The Surgical Management of Motility Disorders

Overview

Journal Dysphagia

Date 1993 Jan 1

PMID 8467721

Citations 4

Authors

H Feussner

W Kauer

J R Siewert

Affiliations

Soon will be listed here.

Abstract

Surgical treatment is either the therapy of choice or a facultative procedure in various types of esophageal motility disorders. In achalasia, cardiomyotomy, frequently combined with fundoplasty, achieves good or excellent results in > 80% of cases, and is, therefore, advised in cases when pneumostatic dilatation fails. Diverticulectomy and myotomy of the upper or lower esophageal sphincter are proven procedures to treat cervical and epiphrenic diverticula, leading to good/excellent results or at least an improvement in more than 95%. If, exceptionally, parabronchial diverticula require therapy, they should be excised transthoracically. Cervical myotomy is indicated in cases of cervical achalasia, when sufficient pharyngeal propulsion is preserved. In systemic diseases like scleroderma reflux induced complications may require surgical intervention in medically intractable cases. In these rather few cases, subtotal gastrectomy with a Roux-en-Y anastomosis is advised. In patients suffering from diffuse esophageal spasm or symptomatic "nutcracker" esophagus, extended esophageal myotomy can relieve symptoms. If a clear diagnosis is provided, about 75% of patients will have an improvement of symptoms.

Citing Articles

Successful surgical treatment for diffuse esophageal spasm.

Maruyama K, Motoyama S, Okuyama M, Ohta H, Ogawa J Jpn J Thorac Cardiovasc Surg. 2005; 53(3):169-72.

PMID: 15828301 DOI: 10.1007/s11748-005-0027-5.

[Laparoscopic esophagotomy without diverticular resection for treating epiphrenic diverticulum in hypertonic lower esophageal sphincter].

Muller A, Halbfass H Chirurg. 2004; 75(3):302-6 discussion 307.

PMID: 15024477 DOI: 10.1007/s00104-003-0792-6.

Treatment of achalasia: the short-term response to botulinum toxin injection seems to be independent of any kind of pretreatment.

Storr M, Born P, Frimberger E, Weigert N, Rosch T, Meining A BMC Gastroenterol. 2002; 2:19.

PMID: 12175425 PMC: 122056. DOI: 10.1186/1471-230x-2-19.

Current concepts on pathophysiology, diagnosis and treatment of diffuse oesophageal spasm.

Storr M, Allescher H, Classen M Drugs. 2001; 61(5):579-91.

PMID: 11368284 DOI: 10.2165/00003495-200161050-00004.

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