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Herbella et al. Mini-invasive Surg 2019;3:24 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2019.20

Perspective Open Access

Minimally invasive surgery for non-achalasia
primary esophageal motility disorders is currently
underused

Fernando A. M. Herbella , Francisco Schlottmann 2
1
1 Department of Surgery, Federal University of Sao Paulo, Sao Paulo, SP 04037-003, Brazil.
2 Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aires C1118 AAT, Argentina.

Correspondence to: Dr. Fernando A. M. Herbella, Department of Surgery, Escola Paulista de Medicina, Federal University of
Sao Paulo, Rua Diogo de Faria 1087 cj 301, Sao Paulo, SP 04037-003, Brazil. E-mail: herbella.dcir@epm.br

How to cite this article: Herbella FAM, Schlottmann F. Minimally invasive surgery for non-achalasia primary esophageal
motility disorders is currently underused. Mini-invasive Surg 2019;3:24. http://dx.doi.org/10.20517/2574-1225.2019.20

Received: 2 Jul 2019 Accepted: 16 Jul 2019 Published: 12 Aug 2019
Science Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Tian Zhang

Abstract
Surgical treatment for non-achalasia primary esophageal motility disorders is reserved for few situations. Proper
selection of patients brings good outcomes with low morbidity, which makes surgical therapy an adequate
therapeutic option. High resolution manometry reclassifies esophageal motility disorders. Interestingly, literature
is scarce on surgical therapy for this new classification with per oral endoscopic myotomy as the leading
treatment.

Keywords: Esophageal manometry, motility disorders, distal esophageal spasm, jackhammer esophagus

High resolution manometry reclassifies esophageal motility disorders based on the Chicago 3.0
[1]
classification . Even though there is a certain correspondence between previous and current
[2]
classifications , a distinct nomenclature arrived based on newly developed - and putatively more objective
and accurate - parameters. Thus, primary esophageal motility disorders (PEMD) are probably better
diagnosed and evaluated.

Achalasia is surely the most understood PEMD. Other PEMD are not as well comprehended nor have
defined therapy options. These other diseases defined by specific manometric pictures may occur as PEMD
[3]
or secondary to gastroesophageal reflux disease (GERD) . If GERD is present, the motility abnormality is
© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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