Association of Esophageal and Pulmonary Diseases

Achalasia of the Cardia

“…While it is possible to perform Heller's operation satisfactorily through the abdomen in the early stage of this disease, it is technically impossible and even dangerous to attempt this route in the late stages with a sigmoid loop of oesophagus and peri-oesophagitis present in the mediastinum. Many of the indifferent results from Heller's operation have been due to a transabdominal approach and final success has only been achieved after a second thoracic operation, The correct pre-operative preparation for a patient in the 3rd stage of achalasia is essential for a satisfactory result and this has been stressed by Belsey (1963). Oesophagoscopy must be performed in order to empty the oesophagus and make the anaesthetic safer, and also to exclude a carcinoma.…”