Paediatric achalasia - what is different?

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Esophageal Motility Disorders

Background:

• Achalasia is a rare esophageal motility disorder impacting children, presenting challenges in symptom management.
• Current treatments for achalasia lack a definitive cure, necessitating effective interventions for symptom control.

Purpose of the Study:

• To evaluate the safety and efficacy of Laparoscopic Heller myotomy (LHM) in pediatric patients with achalasia.
• To assess long-term outcomes and complications following LHM in a pediatric cohort.

Main Methods:

• Retrospective longitudinal cohort study of pediatric achalasia patients (2005-2022).
• All patients underwent Laparoscopic Heller myotomy (LHM) with Dor fundoplicature.
• Data collected on patient demographics, presentation, diagnostic methods, and postoperative outcomes.

Main Results:

• Sixteen pediatric patients (81.2% male, mean age 11.6 years) with achalasia were included.
• Solid dysphagia was the most common symptom (93.8%).
• LHM provided immediate symptom relief; 12.5% required endoscopic dilatation for relapse, and 18.8% developed GERD. No re-operations were needed.

Conclusions:

• Laparoscopic Heller myotomy (LHM) is a safe and effective treatment for symptomatic relief in pediatric achalasia.
• Achalasia remains without a proven cure, highlighting the need for ongoing patient surveillance.
• Close follow-up is essential for long-term disease management and control in pediatric achalasia patients.