Intraoperative manometry: adjunct to surgery for esophageal motility disorders.

Intraoperative manometry can provide an objective means of determining the correct length of myotomy in patients with esophageal motility disorders. Of the patients in this series who underwent primary repair, 94 percent were relieved of pain and dysphagia. One patient required repeat myotomy for vigorous achalasia. After a mean follow-up period of 33 months, gastroesophageal reflux had not developed in any patient, indicating that myotomy with intraoperative manometry eliminates the need for an antireflux procedure. Such a procedure in these patients with poor esophageal motility can lead to dysphagia and obstruction, which is a very difficult problem to correct. We recommend intraoperative manometric be used routinely with myotomy for esophageal motility disorders.