Oesophagus: achalasia treatment: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Surgery · Oesophagus: achalasia treatment

Sample item

A fit 28-year-old with confirmed achalasia cardia asks for the most durable surgical treatment. Which operation is the classical choice?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Laparoscopic Heller myotomy with partial fundoplication

A Heller cardiomyotomy divides the muscle of the lower oesophageal sphincter and the proximal stomach. A partial (Dor or Toupet) fundoplication is added to prevent postoperative reflux. Pneumatic dilatation is the main alternative, while oesophagectomy is kept for end-stage megaoesophagus.

Option by option

  • A. Nissen total fundoplication alone

    A tight total wrap without myotomy would worsen the obstruction.

  • B. Laparoscopic Heller myotomy with partial fundoplication (correct)

    Correct. Myotomy relieves the functional obstruction and the partial wrap controls reflux.

  • C. Transhiatal oesophagectomy

    Oesophagectomy is reserved for failed treatment or sigmoid megaoesophagus.

  • D. Long-term proton pump inhibitor therapy

    PPIs treat acid, not the failure of sphincter relaxation.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is B, Laparoscopic Heller myotomy with partial fundoplication. A Heller cardiomyotomy divides the muscle of the lower oesophageal sphincter and the proximal stomach.

Why is "Nissen total fundoplication alone" not the answer?

A tight total wrap without myotomy would worsen the obstruction.

Why is "Transhiatal oesophagectomy" not the answer?

Oesophagectomy is reserved for failed treatment or sigmoid megaoesophagus.

Why is "Long-term proton pump inhibitor therapy" not the answer?

PPIs treat acid, not the failure of sphincter relaxation.

What concept does this question test?

It tests Oesophagus: achalasia treatment in General Surgery. A partial (Dor or Toupet) fundoplication is added to prevent postoperative reflux. Pneumatic dilatation is the main alternative, while oesophagectomy is kept for end-stage megaoesophagus.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oesophagus: achalasia treatment?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.