Ellis F H
Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA.
Dis Esophagus. 1998 Oct;11(4):210-4. doi: 10.1093/dote/11.4.210.
In summary, the role of long esophagomyotomy for patients with DES and related motor disorders remains controversial. The results are poorer than those following esophagomyotomy for achalasia, and long-term postoperative follow-up of these patients is essential because early good results may be misleading. Two methods are considered equally effective in avoiding postmyotomy reflux: a 'short,' 'floppy' wrap of the LES, or a sphincter-sparing myotomy when manometry indicates normal functioning of the sphincter. Rarely is a total thoracic esophagomyotomy indicated. Because persistent or recurrent pain is the main cause of poor results, some patients may eventually require total esophagectomy and cervical esophagogastrostomy.
