When is esophagectomy indicated in the surgical treatment of esophageal spasm?

Updated: Aug 07, 2019
  • Author: Ahmad Malas, MD; Chief Editor: BS Anand, MD  more...
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Answer

As a last resort, esophagectomy can be used to relieve symptoms. The esophagus is resected, and the stomach, small intestine, or colon is used to restore the continuity of the GI tract. Morbidity and mortality of esophagectomy are substantial; therefore, this procedure should be performed only after other treatments have been exhausted.

Overall, surgical therapy is reserved for those refractory to medical therapy. Filicori et al concluded that chest pain and dysphagia can be effectively palliated with per oral endoscopic myotomy (POEM) in patients with non-achalasia disorders of the esophagus. [27]

A thoracoscopy with a long myotomy from the arch of the aorta across the LES with an antireflux surgery is a commonly performed procedure in this setting.


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