Achalasia is a primary motility disorder of the esophagus, and while there are several treatment options, there is no consensus regarding them. When therapeutic intervention for achalasia fails, a careful evaluation of the cause of the persistent or recurrent symptoms using upper endoscopy, esophageal manometry, and contrast radiologic studies is required to understand the cause of therapy failure and guide plans for subsequent treatment. Options for reintervention are the same as for primary intervention and include pneumatic dilation, botulinum toxin injection, peroral endoscopic myotomy, or redo esophageal myotomy. When reintervention fails or if the esophagus is not amenable to intervention and the disease is considered end‐stage, esophagectomy is the last option to manage recurrent achalasia.

中文翻译：

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贲门失弛缓症：面对海勒肌切开术失败怎么办

贲门失弛缓症是食道的一种原发性运动障碍，虽然有多种治疗选择，但尚未达成共识。当贲门失弛缓症的治疗干预失败时，需要使用上消化道内窥镜检查、食管测压和对比放射学研究仔细评估持续或复发症状的原因，以了解治疗失败的原因并指导后续治疗计划。再介入的选择与初级介入相同，包括气动扩张、肉毒杆菌毒素注射、经口内窥镜肌切开术或重做食管肌切开术。当再干预失败或食管不适合干预且疾病被认为是终末期时，食管切除术是治疗复发性贲门失弛缓症的最后选择。