A National Experience in Paediatric Achalasia: Symptom Recurrence, Reintervention, and Transition Challenges

Area of Science:

• Pediatric Gastroenterology
• Surgical Innovation
• Quality of Life Research

Background:

• Esophageal achalasia is a chronic condition requiring long-term management.
• Interventions aim to alleviate symptoms but may not provide a permanent cure.

Purpose of the Study:

• To evaluate the long-term outcomes and quality of life (QOL) in pediatric patients treated for achalasia.
• To assess the effectiveness of interventions over an 18-year period.

Main Methods:

• Retrospective review of 31 pediatric achalasia patients (2006-2024).
• Analysis of demographics, surgical techniques, and pre/post-intervention Eckardt scores.
• Post-intervention QOL assessment using Eckardt and Achalasia Scoring Questionnaire (ASQ).

Main Results:

• 28 patients analyzed; 75% underwent laparoscopic Heller myotomy.
• Mean follow-up of 7.6 years; mean pre-op Eckardt score 6.9, post-op 2.9.
• 57% transitioned to adult care; current mean ASQ score 19.4 (indicating persistent symptoms).

Conclusions:

• Achalasia interventions provide initial relief but require ongoing management.
• Lifelong follow-up and smooth transition to adult care are crucial for QOL.
• ASQ tool can aid outpatient monitoring of achalasia patients.