Cardia achalasia is a disorder of esophageal motility caused by primary esophageal neuromuscular lesions. It is characterized by loss of normal movement of the esophageal body and poor relaxation of the lower esophageal sphincter during swallowing. The main manifestations are: dysphagia, regurgitation, chest pain, etc. The decrease or absence of the nerves that relax the LES in the interosseous plexus of the LES is the cause. Gastroesophageal reflux disease (GERD), a condition in which reflux of gastric contents causes uncomfortable symptoms and/or complications. It is associated with decreased lower esophageal sphincter pressure, transient lower esophageal sphincter relaxation, decreased esophageal acid clearance, attack of gastric acid and duodenal reflux, esophageal hiatal hernia, and genetic factors. The main manifestations are reflux symptoms mainly acid reflux, regurgitation, belching, heartburn (burning sensation behind the sternum), chest pain and other irritating symptoms of reflux; cough, asthma, pharyngitis, tinnitus, ear itching and other irritating symptoms outside the esophagus. The above two diseases will have dysphagia, regurgitation and chest pain, so how to identify these symptoms when they appear in life? As we all know, the food importation reaches to the stomach through the peristalsis of the esophagus; in order to make the food feeding to the stomach not reflux to the stomach, the human anatomy sets many anti-reflux barriers, for example, the upper and lower esophageal sphincter are under certain pressure (in common parlance, the lower esophagus opens when eating and closes after eating), too tight food cannot pass, too loose, the stomach contents come up easily. In common parlance, the lower sphincter of the esophagus is too tight, so food cannot pass to the stomach normally and accumulates in the esophagus, causing dysphagia, chest pain and regurgitation, and the regurgitated food is undigested food; usually 60% of people have difficulty swallowing liquids and 98% of people have difficulty swallowing solids, which is different from the pathogenesis of regular dysphagia from solids to fluids to liquids in esophageal cancer patients. Gastroesophageal reflux disease is because the lower esophageal sphincter is too relaxed and the food cannot be effectively blocked when it reaches the stomach, and the regurgitated food is semi-digested chyme, usually accompanied by regurgitation of gastric contents, such as stomach acid, etc. The regurgitated material stimulates the esophagus and can cause chest pain and dysphagia. If the symptoms are atypical and cannot be determined, upper gastrointestinal angiography can be performed to clarify the diagnosis. Because the gastroscope is about 1 cm wide, when the cardia failure is not serious, it can pass smoothly and is not easily detected. Therapeutically, there is no treatment that can reverse the neurological alterations and damaged lower esophageal sphincter to restore relaxation and peristalsis. The aim of treatment is to reduce lower esophageal sphincter pressure, enhance contouring ability, reduce esophageal tension and prevent complications, and the effectiveness of treatment can only be evaluated by improvement of symptoms and function. The main treatment methods are as follows: 1. Drug therapy: drugs to reduce the pressure of the lower esophageal sphincter, such as: anticholinergics, amyl nitrite, sublingual isosorbide nitrate, theophylline and β2 agonists; isosorbide nitrate or nifedipine is commonly used orally or sublingually before meals, isosorbide nitrate 50-100mg sublingually can reduce the resting pressure of the lower esophageal sphincter by 66%, maintained for 90 min. Calcium channel blockers (nifedipine, isobodine) reduce the lower esophageal sphincter pressure by 30-40% and maintain it for more than 1 h. However, oral drugs are mild and short-lived. Therefore, they are only used for temporary relief of dysphagia or for preoperative preparation. 2, botulinum toxin injection therapy: botulinum toxin (BTX) is an exotoxin produced by Clostridium botulinum of the genus Clostridium, a protein with a molecular weight of about 15000, the mechanism is to destroy the acetylcholine receptors of nerve endings and intermuscular plexus, inactivate acetylcholine, reduce the excitatory effect of cholinergic nerves on LES, relax the LES, thus relieving the symptoms. Compared with balloon dilation or myotomy, BTX injection therapy has fewer adverse effects, and a few patients have chest pain symptoms, but they can be relieved quickly.BTX injection therapy also has its limitations, it still cannot restore the peristaltic function of the esophagus; the validity period is only about 1 year; some patients need repeated treatment, and the price is relatively high. Therefore, it is suitable for elderly patients and patients with combined other diseases that cannot tolerate surgery and balloon dilation treatment L4J, and can also be used to improve symptoms and nutritional status before surgery. This drug has small adverse effects, but the long-term efficacy and safety are yet to be further studied. 3, sclerotherapy sphincter meat injection treatment: The treatment mechanism may be that sclerotherapy causes necrosis and fibrosis of the lower esophageal sphincter, resulting in scar contracture and reducing its spasm, thus relieving symptoms. Clinical literature reports: sclerotherapy technique is simple and no risk of perforation is its advantage, but this method requires repeated injections and is prone to local erosion and bleeding, ulceration and stricture, which needs further confirmation. 4.Dilatation therapy: There are many types of dilators, and a variety of air-bladder dilators have replaced the probe and water-bladder dilators in the past, using external force to forcefully dilate the lower esophageal sphincter that has lost its relaxation function, causing partial tearing of the lower esophageal sphincter, so as to achieve the treatment purpose. The key to dilatation therapy is whether the cardia stenosis area can be adequately dilated, generally to 3.5-4.5 cm. Most people advocate a single dilatation, while others advocate gradual pressure and multiple dilatations. The current tendency is to use the method of gradually increasing the diameter of the balloon, which can reduce the incidence of esophageal perforation. In some patients with unsatisfactory results, the procedure can be repeated 1-2 times. The main complications of dilatation therapy are: esophageal perforation, aspiration pneumonia, esophageal tear, etc. So far, transballoon dilatation therapy is the most effective non-surgical treatment method, and its short-term efficacy is exact, but its long-term effect is not very satisfactory. 5, surgical treatment: The purpose is to completely cut the lower esophageal sphincter to eliminate the symptoms of dysphagia without causing excessive reflux; surgical treatment is very satisfactory in both short-term and long-term results, with an effective rate of 80%-100%; the application of minimally invasive technology has played a very big role in the surgical treatment of pancreatic atelectasis, and many data confirm that minimally invasive laparoscopic surgery is not only the same as open chest and open abdominal myotomy Many data confirm that minimally invasive laparoscopic surgery not only achieves the same efficacy as open thoracotomy, but also reduces the hospital stay, alleviates postoperative discomfort, shortens the recovery time, and significantly reduces surgical complications.