Abstract
Background Esophageal achalasia (EA) is a rare esophageal motility disorder in children. Laparoscopic Heller myotomy (LHM) represents the treatment of choice in young patients. Peroral endoscopic myotomy (POEM) is becoming an alternative to LHM. The aim of this study is to evaluate the effectiveness, safety, and outcomes of POEM vs LHM in treatment of children with EA. Methods Data of pediatric patients with EA, who underwent LHM and POEM from February 2009 to December 2013 in two centers, were collected. Results Eighteen patients (9 male, mean age: 11.6 years; range: 2-17 years) were included. Nine patients (6 male, mean age: 10.7 years; range: 2-16 years) underwent LHM, and the other 9 (3 males, mean age: 12.2 years; range: 6-17 years) underwent POEM procedure. Mean operation time was shorter in POEM group compared with LHM group (62/149 minutes). Myotomy was longer in POEM group than in LHM group (11/7 cm). One major complication occurred after LHM (esophageal perforation). No clinical and manometric differences were observed between LHM and POEM in follow-up. The incidence of iatrogenic gastroesophageal reflux disease was low (1 patient in both groups). Conclusions Results of a midterm follow-up show that LHM and POEM are safe and effective treatments also in children. Besides, POEM is a mini-invasive technique with an inferior execution timing compared to LHM. A skilled endoscopic team is mandatory to perform this procedure.
| Original language | English |
|---|---|
| Pages (from-to) | 726-730 |
| Number of pages | 5 |
| Journal | Journal of Pediatric Surgery |
| Volume | 50 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - May 1 2015 |
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Keywords
- esophageal achalasia
- esophageal manometry
- Heller myotomy
- POEM
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health
- Medicine(all)
Cite this
Treatment of esophageal achalasia in children : Today and tomorrow. / Caldaro, Tamara; Familiari, Pietro; Romeo, Erminia Francesca; Gigante, Giovanni; Marchese, Michele; Contini, Anna Chiara Iolanda; Federici Di Abriola, Giovanni; Cucchiara, Salvatore; De Angelis, Paola; Torroni, Filippo; Dall'Oglio, Luigi; Costamagna, Guido.
In: Journal of Pediatric Surgery, Vol. 50, No. 5, 01.05.2015, p. 726-730.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Treatment of esophageal achalasia in children
T2 - Today and tomorrow
AU - Caldaro, Tamara
AU - Familiari, Pietro
AU - Romeo, Erminia Francesca
AU - Gigante, Giovanni
AU - Marchese, Michele
AU - Contini, Anna Chiara Iolanda
AU - Federici Di Abriola, Giovanni
AU - Cucchiara, Salvatore
AU - De Angelis, Paola
AU - Torroni, Filippo
AU - Dall'Oglio, Luigi
AU - Costamagna, Guido
PY - 2015/5/1
Y1 - 2015/5/1
N2 - Background Esophageal achalasia (EA) is a rare esophageal motility disorder in children. Laparoscopic Heller myotomy (LHM) represents the treatment of choice in young patients. Peroral endoscopic myotomy (POEM) is becoming an alternative to LHM. The aim of this study is to evaluate the effectiveness, safety, and outcomes of POEM vs LHM in treatment of children with EA. Methods Data of pediatric patients with EA, who underwent LHM and POEM from February 2009 to December 2013 in two centers, were collected. Results Eighteen patients (9 male, mean age: 11.6 years; range: 2-17 years) were included. Nine patients (6 male, mean age: 10.7 years; range: 2-16 years) underwent LHM, and the other 9 (3 males, mean age: 12.2 years; range: 6-17 years) underwent POEM procedure. Mean operation time was shorter in POEM group compared with LHM group (62/149 minutes). Myotomy was longer in POEM group than in LHM group (11/7 cm). One major complication occurred after LHM (esophageal perforation). No clinical and manometric differences were observed between LHM and POEM in follow-up. The incidence of iatrogenic gastroesophageal reflux disease was low (1 patient in both groups). Conclusions Results of a midterm follow-up show that LHM and POEM are safe and effective treatments also in children. Besides, POEM is a mini-invasive technique with an inferior execution timing compared to LHM. A skilled endoscopic team is mandatory to perform this procedure.
AB - Background Esophageal achalasia (EA) is a rare esophageal motility disorder in children. Laparoscopic Heller myotomy (LHM) represents the treatment of choice in young patients. Peroral endoscopic myotomy (POEM) is becoming an alternative to LHM. The aim of this study is to evaluate the effectiveness, safety, and outcomes of POEM vs LHM in treatment of children with EA. Methods Data of pediatric patients with EA, who underwent LHM and POEM from February 2009 to December 2013 in two centers, were collected. Results Eighteen patients (9 male, mean age: 11.6 years; range: 2-17 years) were included. Nine patients (6 male, mean age: 10.7 years; range: 2-16 years) underwent LHM, and the other 9 (3 males, mean age: 12.2 years; range: 6-17 years) underwent POEM procedure. Mean operation time was shorter in POEM group compared with LHM group (62/149 minutes). Myotomy was longer in POEM group than in LHM group (11/7 cm). One major complication occurred after LHM (esophageal perforation). No clinical and manometric differences were observed between LHM and POEM in follow-up. The incidence of iatrogenic gastroesophageal reflux disease was low (1 patient in both groups). Conclusions Results of a midterm follow-up show that LHM and POEM are safe and effective treatments also in children. Besides, POEM is a mini-invasive technique with an inferior execution timing compared to LHM. A skilled endoscopic team is mandatory to perform this procedure.
KW - esophageal achalasia
KW - esophageal manometry
KW - Heller myotomy
KW - POEM
UR - http://www.scopus.com/inward/record.url?scp=84928697875&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84928697875&partnerID=8YFLogxK
U2 - 10.1016/j.jpedsurg.2015.02.047
DO - 10.1016/j.jpedsurg.2015.02.047
M3 - Article
C2 - 25783358
AN - SCOPUS:84928697875
VL - 50
SP - 726
EP - 730
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
IS - 5
ER -