Surgical management of XXXX .

@entity1 @entity1318 @entity295 @entity4773 @entity583
Between 1970 and 1983, 46 @entity1 were hospitalized in the Vanderbilt University Medical Center and the Metropolitan Nashville General Hospital for treatment of @entity1318 . All @entity1 had been symptomatic for at least two years. Efforts were made initially to manage most of these @entity1 (40) with periodic esophageal dilatation. This was successful in only six cases (15%). In four instances (10%), @entity1 had esophageal perforation. Thirty @entity1 have had esophagomyotomy (Heller procedure), and 14 of these had an associated antireflux procedure. Three had proximal gastric vagotomy for associated @entity4773 . Twenty-seven (90%) have had a good result, three died postoperatively, and two elderly @entity1 had @entity583 . The other @entity1 had @entity295 after repair of a perforated esophagus. While periodic esophageal dilatation is necessary in @entity1 who may not tolerate an operative procedure, most @entity1 with @entity1318 are best treated with Heller esophagomyotomy.
