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Updated: May 19, 2026
Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Retrospective analysis of paediatric achalasia in India: single centre experience
Sunita Singh1, Ashish Wakhlu, Anand Pandey
1Department of Pediatric Surgery, CSM Medical University (Erstwhile King George Medical University), Lucknow, India.
Insights
Paediatric achalasia treatment in India shows promising results. Cardiomyotomy with partial fundoplication is effective for children, improving symptoms and quality of life.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Esophageal Motility Disorders
Background:
- Paediatric achalasia is a rare esophageal motility disorder.
- Management strategies in developing countries require specific considerations.
- Tertiary referral centers play a crucial role in managing complex pediatric cases.
Purpose of the Study:
- To share the experience of managing paediatric achalasia in an Indian tertiary referral center.
- To evaluate the effectiveness of surgical intervention for paediatric achalasia.
- To assess treatment outcomes from the parents' perspective.
Main Methods:
- Retrospective analysis of pediatric patients (<16 years) operated for achalasia.
- Data collected from December 1998 to December 2011.
- Inclusion criteria focused on patients with adequate follow-up.
Main Results:
- 40 pediatric patients underwent surgery for achalasia over 13 years.
- Common symptoms included regurgitation and failure to thrive.
- Significant improvement in symptom scores was observed post-surgery (P < 0.012).
- Low complication rates and no treatment failures reported in mean follow-up.
Conclusions:
- Cardiomyotomy with partial fundoplication is the preferred treatment for paediatric achalasia.
- This surgical approach demonstrates favorable outcomes and parent satisfaction.
- Effective management is achievable even in resource-limited settings.
Background:
Developing countries at tertiary referral centre. The aim of this study was to share our experience of paediatric achalasia in Indian scenario.
Materials And Methods:
This was a retrospective analysis of children <16 years, operated for achalasia at our centre, from December 1998 to December 2011.
Results:
Total 40 patients (mean age 39 ± 4.29 months), including 1 patient of megaesophagus were operated over 13 years of period; 17 patients (associated congenital H-type tracheoesophageal fistula in one patient, non- responders/ lost follow-up for minimum of 3 years in 16 patients) were excluded from the study. The response rate of parents in follow-up was 60.0%. Mean symptoms duration was 27.88 ± 2 months. Most common symptoms were regurgitation and failure to thrive (78.2%). Mean symptom scoring in follow-up after 3 year was 1 ± 0.7 compared to 5 ± 0.51 at the time of admission (P < 0.012). One infant expired (mediastenitis), one developed adhesive intestinal obstruction and one needed posterior re-myotomy (for megaesophagus). There were no treatment failures in mean follow-up of 40.2 ± 5.07 months.
Conclusions:
Cardiomyotomy with partial fundoplication is the best modality of treatment for paediatric achalasia cardia, even from parents' perspective.
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