What is the recommended surgical intervention for Chagas disease causing achalasia?

Chagas disease can lead to achalasia due to the destruction of the autonomic neurons in the esophagus, resulting in impaired peristalsis and the inability of the lower esophageal sphincter to relax properly. The primary goal of surgical intervention in cases of achalasia is to alleviate the obstruction at the lower end of the esophagus.

Heller myotomy is the most effective surgical procedure for treating achalasia. This procedure involves making an incision in the lower esophageal sphincter muscle to allow for the passage of food through the esophagus into the stomach. By reducing the tone of the esophageal sphincter, the myotomy helps restore normal swallowing function and alleviates symptoms like dysphagia and chest pain associated with achalasia.

While other options might provide temporary relief or be used in different contexts, they do not address the underlying issue as effectively as a Heller myotomy. For instance, fundoplication is typically used for gastroesophageal reflux disease and doesn't directly relieve the obstruction in achalasia. Balloon dilation can offer symptomatic relief but may not provide a permanent solution and can lead to complications. Partial resection is not standard for achalasia management since removing a section of the esophagus does