Esophagomyotomy for achalasia of the esophagus

Currently conflicting opinions regarding the efficacy of esophagomyotomy alone as the preferred treatment for esophageal achalasia prompted this review of the results in 69 patients treated at the Lahey Clinic between January 1970 and January 1980. Preoperative symptoms were alleviated completely or partially in 92% of the 60 patients operated on more than 12 months ago and who were available for follow-up study (average: 42 months). Excellent or good results were achieved in 84% of patients. Only one of the poor results was due to reflux esophagitis. It is concluded that an antireflux procedure is not routinely necessary to prevent postoperative reflux esophagitis if the technique of esophagomyotomy follows certain specific guidelines.