**3. Esophageal mucosectomy - historical aspects and indications**

The idea of removing the esophageal mucosa and submucosa by invagination, preserving the tunica muscle at the mediastinal level, dates back to 1914 with the pioneering works of Rehn (apud Kirschner [61]). This author, concerned at the time with mediastinal hemorrhages and pleural lesions which occurred in the case of esophageal stripping via the cervical abdominal route in experimental surgery in dogs, conceived the experimental model by extracting only the mucosal and submucosal cylinders through the same route. However, due to the low impact of his method and for not being able to standardize an adequate reconstruction of the cervical esophagus with the stomach, he abandoned his propositions.

Later, other authors demonstrated, in clinical experience, the validity of this procedure in patients with caustic esophagitis, carcinoma of the distal esophagus and of the proximal portion of the stomach [62, 63].

As Brazil is a country with a high incidence of achalasia, mainly due to Chagas etiology, Aquino et al. [64] recommended this type of procedure, initially carrying out an experimental study in dogs, demonstrating its feasibility. Further studies on human cadavers demonstrated the feasibility of this method.

Thus, supported by this experimental verification, our clinical experience began with good evolution in the initial evaluation [65], and recently the great validity of this procedure was demonstrated in 131 patients with advanced achalasia with esophageal diameter greater than 10 cm.
