BACKGROUND: To evaluate the surgical treatment results in a series of patients submitted to previous treatments for megaesophagus, which their symptoms recurred. METHOD: We analyzed the results of many different surgical techniques performed in 47 patients at the General and Thoracic Surgery Department of HMCP-PUC-Campinas. Our follow-up considered postoperative results as follows: development of new symptoms, relief of old symptoms, morbidity, and mortality. We divided the patients in three groups in accordance to the disease degree: Incipient (9 cases), not advanced (18 cases) and advanced (20 cases). The techniques used were Heller's modified cardiomyotomy, Thal's esophagocardioplasty, Serra-Dória's esophagocardioplasty, subtotal esophagectomy with mucosectomy and conservation of the esophagus muscular layer. RESULTS: For incipient megaesophagus, the cardiomyotomy technique obtained good results, with low morbidity. For not advanced megaesophagus, the cardioplasty, in special the Serra Dória's esophagocardioplasty, was the best choice. The procedures used for advanced megaesophagus had the greatest morbidity rates; however, they also showed superiority for aggressive techniques comparing with the conservative operations, in special the mucosectomy with conservation of the esophagus muscular layer, being this the technique with less morbidity within this group. CONCLUSION: It is difficult to choose a standard procedure for megaesophagus with previous surgical treatment due to several available techniques, and different personal surgeon skills, in such way to create therapeutical protocols.
Esophageal achalasia; Surgery; Deglutition disorders