Pathogenesis, clinical manifestations, diagnosis, and treatment progress of achalasia of cardia

Table 6 Surgical treatment of achalasia

Procedure	Indication	Complication
Peroral endoscopic myotomy	Advanced sigmoidocardia achalasia; surgical myotomy failed; patients with achalasia cardia who have previously received endoscopic treatment; spastic esophageal dyskinesia, such as jackhammer esophagus; diffuse esophageal spasm; hypertensive lower esophageal sphincter; nutcracker esophageal dyskinesia	Mucosal perforation; subcutaneous emphysema; pneumoperitoneum; pneumothorax; mediastinal emphysema; pleural effusion and pneumonia; delayed bleeding; infection; gastroesophageal reflux disease
Laparoscopic Heller myotomy	Drug treatment if symptomatic improvement is not obvious	Gastroesophageal reflux disease; punch
Stent implantation	Patients who are not candidates for surgery	Mucosal hyperplasia; local esophageal stenosis; scaffold migration
Esophagectomy	A zigzag giant esophagus; esophageal stenosis caused by reflux	Leakage