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Use of the Scissor-Type Knife During the Peroral Endoscopy Myotomy Procedure for the Treatment of Achalasia
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Per oral endoscopic myotomy (POEM) in pediatric patients with esophageal achalasia: First Latin-American experience

Josefina Saez1, Ricardo Mejia2, Juan Carlos Pattillo1

  • 1Pediatric Surgery Section, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.

Journal of Pediatric Surgery
|July 11, 2020
PubMed

Insights

Per-oral endoscopic myotomy (POEM) is a safe and effective treatment for pediatric achalasia, resolving dysphagia in all patients. This study supports POEM as a viable option for children with this esophageal motility disorder.

Area of Science:

  • Gastroenterology
  • Pediatric Surgery
  • Endoscopic Procedures

Background:

  • Achalasia is a rare primary esophageal motor disorder in children.
  • Laparoscopic Heller myotomy (LHM) is the standard surgical treatment.
  • Per-oral endoscopic myotomy (POEM) is an emerging alternative in adults.

Purpose of the Study:

  • To evaluate the safety and effectiveness of POEM in pediatric achalasia patients.
  • To report outcomes from a Chilean medical center cohort.

Main Methods:

  • Retrospective analysis of prospectively collected data.
  • Inclusion of pediatric patients undergoing POEM for achalasia.
  • Clinical follow-up using Eckardt score, high-resolution esophageal manometry (HREM), and endoscopy.

Main Results:

  • Five pediatric patients (mean age 11) underwent POEM (2017-2019).
  • One patient had prior LHM; no morbidity or mortality observed.
  • All patients achieved dysphagia resolution with a significant reduction in Eckardt score (10 to 1).

Conclusions:

  • POEM demonstrates safety and effectiveness in pediatric achalasia.
  • Further research with larger cohorts and longer follow-up is warranted.
  • POEM shows promise as a treatment for pediatric achalasia.
Abstract

Keywords:
AchalasiaChildrenMyotomyPOEM

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