Endoluminal vs. extraluminal cardiomyotomy for oesophageal achalasia

Oesophageal achalasia is a relatively rare disorder characterized by the absence of peristalsis along the oesophageal body and failure of the lower oesophageal sphincter (LOS) to relax; as a consequence the food bolus often gets stuck in the distal oesophagus and the patient experiences dysphagia. Other related symptoms are regurgitation and chest pain. Although the exact causes of achalasia are still not known [there are some suggestions to a possible autoimmune pathogenesis activated by herpes simplex viruses (1)], the medical community has long been aware of how to alleviate the related dysphagia even before fully understanding the pathophysiology of the disease.