title: Surgical treatment for nonspecific esophageal motility disorders.
abstract: OBJECTIVE
  Nonspecific esophageal motility disorder (NEMD) is a vague category that includes patients with poorly defined contraction abnormalities observed during esophageal manometry. This study investigated the therapeutic effects of the video-assisted thoracoscopic surgery (VATS) approach using long myotomy and fundopexy for NEMD.
  
  
  METHODS
  The VATS approach using myotomy and fundopexy was performed for 4 patients of NEMD between 2005 and 2008. A total of 4 patients with NEMD that underwent treatment at our institution were analyzed retrospectively.
  
  
  RESULTS
  The patients included 2 males and 2 females with a median age of 48 years (range 21-74 years). The median duration of NEMD symptoms was 58 months (range 4-108 months). Dysphagia was a primary symptom in all patients. Chest pain was a primary symptom in 3 of 4 patients (75 %). Treatment with medication was attempted before the operation. The median operative time was 344.5 min (range 210-476 min). The median time before starting oral feeding was 2.5 days (range 2-22 days). All patients achieved a significant improvement of their previous condition.
  
  
  CONCLUSIONS
  The VATS approach using myotomy and fundopexy for NEMD is a good treatment in cases resistant to medication and balloon dilation.
authors.affiliation: Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Gunma, 371-8511, Japan. inose@med.gunma-u.ac.jp
authors.forename: Takanori
authors.initials: T
authors.lastname: Inose
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Shigemasa
authors.initials: S
authors.lastname: Suzuki
authors.forename: Naritaka
authors.initials: N
authors.lastname: Tanaka
authors.forename: Makoto
authors.initials: M
authors.lastname: Sakai
authors.forename: Akihiko
authors.initials: A
authors.lastname: Sano
authors.forename: Takehiko
authors.initials: T
authors.lastname: Yokobori
authors.forename: Makoto
authors.initials: M
authors.lastname: Sohda
authors.forename: Masanobu
authors.initials: M
authors.lastname: Nakajima
authors.forename: Minoru
authors.initials: M
authors.lastname: Fukuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D000328:Adult; D000368:Aged; D002637:Chest Pain / Q000209:etiology; D003680:Deglutition Disorders / Q000209:etiology; D015154:Esophageal Motility Disorders / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D012189:Retrospective Studies; D020775:Thoracic Surgery, Video-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult