Repair of esophageal perforation after treatment for achalasia

Esophageal perforation after treatment for achalasia is a devastating compl ication. Successful closure of the perforation and relief of the obstructio n from achalasia are paramount. This can be accomplished by careful closure of the mucosa. The mucosal closure is buttressed by a pedicled intercostal muscle carefully sewn to the edges of the muscular defect. This approach d eals effectively with the perforation and maintains the myotomy for relief of esophageal obstruction from achalasia. (C) 2000 by The Society of Thorac ic Surgeons.