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Updated: Jun 11, 2025
Robotic Myotomy and Partial Fundoplication for Achalasia
Published on: August 11, 2023
Peroral endoscopic myotomy (POEM) as a treatment for pediatric achalasia: multicenter study and first results
Carlos Leganés Villanueva1, Eduardo Albéniz Arbizu2, Ilaria Goruppi1
1Departamento de Cirugía Pediátrica, Servicio de Pediatría, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, España.
Introduction:
Laparoscopic Heller miotomy of achalasia has been classically recognized as the gold standard management in children. There is increasing experience with the peroral endoscopic miotomy (POEM) approach in pediatrics, although the series published are scarce. The objective of this study was to present our experience in primary or secondary treatment of pediatric achalasia by POEM and its clinical success rate.
Methods:
We performed a retrospective review of pediatric patients with achalasia who underwent POEM in some national centers from October 2016 to January 2023. We evaluated clinical efficacy (Eckardt score ≤3), demographic characteristics, intraoperative, preoperative and postoperative, complications, and follow-up.
Results:
Fifteen POEM were performed in fourteen pediatric patients (aged 12 to 18 years) with achalasia. POEM was the first line treatment in 11 patients, but 4 (21.3%) had previous treatment: 1 (7,1%) pneumatic balloon dilation and 2 (14,2%) laparoscopic Heller myotomy and 1 (7,1%) previous POEM. The average age was 15 years (SD±1,9). The baseline Eckardt score was 7,5 (SD:±1,8), with the baseline GERD score being 6 (SD:±2,9). There was a Clavien-Dindo grade 2 postoperative adverse event corresponding to mild pneumonia (7,1%). The postoperative Eckardt and GERD score after 12 months of follow-up were 0.7 (SD±1,2) and 0,5 (SD±0,7). The study has a success rate greater than 93%.
Conclusions:
POEM seems a safe and effective procedure, with a short postoperative period for treatment of pediatric achalasia.
