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15236 Surgery

A patient has been diagnosed with achalasia. He refused surgery initially, preferring to try nonoperative therapy. He tried life-style modification, calcium channel blockers, botulin toxin injection, and endoscopic pneumatic dilatation. None of the treatments alleviated his symptoms. What are his surgical options?

AEsophagectomy
BSurgical esophagomyotomy proximal to the LES
CModified Heller myotomy and partial fundoplication
DRepeat pneumatic dilation using pressures of loops
Surgery
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