**4.1 Early postoperative evaluation**

This assessment was performed with 131 patients with advanced achalasia undergoing this type of surgical procedure. The patients remained in the first *Surgical Treatment of Esophageal Advanced Achalasia DOI: http://dx.doi.org/10.5772/intechopen.99944*

**Figure 3.** *Cervical esophageal mucosa is transected and tied.*

**Figure 5.** *Gastric transpositon to the neck into the muscular tunnel.*

24–48 hours after surgery under the care of the medical team of the Intensive Care Unit, and enteral nutrition was started through the jejunostomy tube, with the reestablishment of intestinal motility.

Oral feedback was instituted after evaluating the integrity of the esophagogastric anastomosis by performing contrast radiography with iodinated substance between the seventh and the tenth postoperative day; in patients with clinical evidence of fistula, depending on its evolution; the day of this examination was variable.

In all patients, a simple chest X-ray was performed in the first 24 hours after surgery and systematically repeated at a 72-hour interval in the first week, or for a shorter period in cases with clinical parameters of pleuropulmonary complications.

The entire sample was initially assessed in terms of morbidity and mortality in the first thirty days after surgery, as well as the treatment for each of the complications.

## **4.2 Late postoperative evaluation**

This assessment was carried out in 85 patients with a variable period of 2 to 5 years after the surgery, and was compared with the preoperative period. The four main clinical symptoms and their intensity was quantified according to the score proposed by Eckardt et al. [66]: (a) DYSPHAGIA: zero - no symptoms; 1- occasional; 2 - daily; 3 - every meal; (b) REGUGITATION: zero - no symptoms; 1- occasional; 2- daily; 3 - every meal; (c) RETROSTERNAL PAIN: zero - no symptoms; 1 - occasional; 2 - daily; 3 - several times a day; WEIGHT LOSS: zero - no loss; 1- <5 kg; 2–5 to 10 kg; 3- > 10 kg.
