It is an esophageal dysmotility disorder of unknown etiology, probably related to neuromuscular dysfunction caused by lesions of the musculocutaneous plexus of the esophageal cardia. The manifestation is characterized by the lack of normal peristaltic waves in the esophageal body, and the lower esophageal cardia sphincter cannot be relaxed in a spastic manner, thus causing obstruction of esophageal emptying and retention of esophagus in the lumen, resulting in significant dilatation of the proximal esophagus, mostly seen in young and middle-aged patients from 20 to 50, with more women than men. Clinical manifestations: 1. The most common symptom is dysphagia, characterized by manifestations unrelated to the nature of the food, the degree is sometimes light and sometimes heavy, with intermittent periods, and can be aggravated by mental and emotional factors. 2, half of the people with spontaneous chest pain, not necessarily related to eating and swallowing, mostly seen in the early stages of the disease or at night. 3.Gastric regurgitation and vomiting: mostly seen after meals or when lying down, and aggravated with disease progression. 4.Sometimes respiratory complications such as aspiration pneumonia, lung abscess, bronchiectasis can be caused by aspiration by mistake. 5.Long-term dysphagia leads to low food intake, which may cause wasting, anemia and malnutrition. Diagnosis: clinical dysphagia + barium esophagogram, esophagoscopy and esophageal motor function examination Barium esophagogram: esophageal body dilatation, peristalsis disappeared inside, lumen narrowing of the esophagogastric junction with bird’s beak-like changes, smooth local mucosa, barium retention, in severe cases, the esophagus is obviously dilated and flexed in an “S” shape. Esophagoscopy: the lumen is wide and smooth, the mucosa is edematous and thickened, with different degrees of inflammatory changes, the cardia is closed, but there is no resistance to the passage of the mirror body. Esophageal motor function manometry: Increased resting pressure in the lumen of the esophagus, approximately equal to the pressure in the fundus, was seen. Treatment: Mainly esophageal myotomy and dilatation. Pressure balloon esophageal dilatation, although postoperative can be eaten, fast recovery, less trauma, easy for patients to accept, but postoperative prone to gastroesophageal reflux, occasional perforation, poor long-term results, can lead to esophageal mucosal scarring and fibrosis, affecting the re-operation treatment. The original transabdominal or transthoracic large incision for esophageal extramucosal myotomy is slow to recover and traumatic after surgery. With the development of cold light source, high-definition camera and imaging system, transthoracoscopic treatment of pancreatic dystocia has been gradually established. Our department now adopts a small transthoracic incision to perform cardia esophageal myotomy, using a small incision in the left chest wall not longer than 10 cm, to completely cut the circular myotomy of the lower esophagus and the gastroesophageal junction, and free and preserve the integrity of the mucosa to completely release the obstruction around the cardia, which has the characteristics and advantages of small trauma, safety and effectiveness, and can achieve the same treatment effect as open surgery under the principle of minimally invasive. Patients can be relieved of swallowing difficulties in the early postoperative period, with less pain and faster recovery.