Evaluation of operations for megaesophagus (cardiospasm)

The balloon-amplified extramucosal myotomy satisfies the requirements of a surgical procedure designed to overcome the pathologic deformity of the esophagus in cardiospasm. Despite the wide separation of muscle and mucosal layers by the balloon distention, the esophagus retains its competence at the esophagogastric juncture and permits ready evacuation of the dilated atonic esophagus. Complete relief of symptoms can be expected following this procedure if it is performed early in the disease before the esophagus becomes markedly enlarged, angulated, and fibrotic in the narrowed segment. Such angulation provides areas of stasis and pooling of food and decreases the chances of an immediate good result. Early diagnosis of cardiospasm will make possible proper surgical treatment under optimal conditions. Rapid and early weight gains postoperatively by these patients attest to the benefits of the operation.