Operation for motor dysfunction of the esophagus.
Modern operative treatment of motor dysfunction of the esophagus began in 1949 with the recognition that anastomotic procedures that bypass or destroy the distal esophageal sphincter are associated with the development of reflux esophagitis and stricture. Thirty years later, reflux esophagitis related to esophagomyotomy or intrinsic esophageal disease remains the dominant concern and challenge. This review examines the current status of operative procedures for the management of three important primary disorders of esophageal motility: achalasia, diffuse esophageal spasm, and scleroderma. Relief of esophageal obstruction by esophagomyotomy or reconstruction is the common surgical goal. The addition of a fundoplication procedure to discourage esophageal reflux remains controversial in each disorder. Esophageal resection may become necessary when stricture persists or esophagomyotomy fails to provide lasting relief of dysphagia.
D004935:Esophageal Diseases / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D004942:Esophagitis, Peptic / Q000601:surgery; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D010528:Peristalsis; D012594:Scleroderma, Localized / Q000150:complications