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Thoracoscopic esophagomyotomy for achalasia in the pediatric population: A retrospective cohort study

Eileen M Duggan1, Samuel Nurko2, Charles J Smithers1

  • 1Department of Surgery, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA, USA.

Journal of Pediatric Surgery
|August 20, 2018
PubMed

Insights

Thoracoscopic esophagomyotomy offers a safe and effective treatment for pediatric achalasia, providing initial symptom relief for most patients. This minimally invasive approach is a viable alternative to traditional methods.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Thoracic Surgery

Background:

  • Achalasia is a rare esophageal motility disorder affecting children.
  • Standard treatments include pneumatic dilation and esophagomyotomy.
  • Minimally invasive esophagomyotomies are favored for reduced pain and shorter hospital stays.

Purpose of the Study:

  • To evaluate the safety and efficacy of thoracoscopic esophagomyotomy in pediatric achalasia patients.
  • To describe the institutional experience with this minimally invasive surgical technique.

Main Methods:

  • Retrospective cohort study of 31 pediatric patients undergoing thoracoscopic esophagomyotomy for achalasia (1995-2016).
  • Endoscopic guidance was utilized in all procedures.
  • No fundoplication was performed concurrently.

Main Results:

  • 97% of patients experienced initial symptom relief post-procedure.
  • Median length of stay was 2 days.
  • 26% of patients required subsequent pneumatic dilations for symptom recurrence, with a higher likelihood if prior dilations were performed.

Conclusions:

  • Thoracoscopic esophagomyotomy is a safe and effective surgical option for pediatric achalasia.
  • This approach should be considered alongside laparoscopic myotomy for treating achalasia in children.
Abstract

Keywords:
AchalasiaPneumatic dilationsThoracoscopic esophagomyotomy

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