“…The modified Heller myotomy accounts for 99% of achalasia operations, at least 56% of surgeons using the transthoracic approach [213], Good to excellent results from csophaAchalasia: W hat's New in Diagnosis and Treatm ent? gomyotomy are obtained in about 90% (range 60-94%) of achalasia patients followed from 1 to 36 years [75,213,214], Esophagomyotomy lowers LES pressure more consistently than pneumatic dilatation [187,[215][216][217][218], Depending on the distal ex tent of the myotomy, LES pressure is lowered by 55-75% with the remaining residual pres sure usually being <10 mm Hg [187,[215][216][217][218], Myotomy also lowers intraesophageal pressure but does not improve LES relaxation [219]. Partial return of peristalsis is reported in up to 14% of patients after myotomy, but these are usually manometric reports without correlation with barium clearance [199,[220][221][222].…”