Asian Journal of Case Reports in Surgery

Achalasia is a rare desease. Treatment options in delayed stages like sigmoid esophagus are heller myotomy and esophagectomy.  This case report aims to show the anatomy variations, strength, and outcomes of esophagectomy with and hybrid technique.

Presentation of Case: A 69-year-old man presented with a long history of dysphagia, regurgitation, and smoking history. An esophagectomy was done. A common complication presented (fistula) and other not so common; pyloric obstruction. Then the patient improved with conservative management.

Discussion: the purpose of this review is to comparate the different treatment options for end-stage achalasia, one of them is esophagectomy which involves a certain degree of difficulty compared to other indications for esophagectomy. Esophagectomy in patients with achalasia seems a safe procedure. Others treatment options used for end-stage achalasia or for failure from other treatment options for achalasia like Heller's myotomy, pneumotic dilatations or POEM.

Conclusion: Treatment options for end-stage achalasia range from conventional treatment (endoscopic, heller myotomy) to esophageal resection, with very specific indications. Morphological alterations in end-stage achalasia are a surgical challenge. Knowledge of postoperative complications and their treatment has important implications for the right management.