Preoperative Investigation Preparation for the Procedure

History and clinical evaluation: Duration of dysphagia, nutritional status

Atelectasis, fibrosis (s/p aspiration pneumonia) Degree of esophageal dilatation and lengthening Non-relaxing lower esophageal sphincter, lack of peristalsis

Rule out esophageal mucosal lesions, Candida colonization, associated gastroduodenal disease

Chest X-ray: Barium swallow study: Esophageal manometry:

Endoscopy:

CT scan and/or endoscopic ultrasound (EUS) in selected patients: Rule out pseudoachalasia (malignancy-induced)

Insert a double-lumen nasogastric tube 12h before surgery to wash and clean the esophageal lumen from food debris Short-term antibiotic and antithrombotic prophylaxis

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