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J Pediatr Surg. 2010 Jun;45(6):1173-7. doi: 10.1016/j.jpedsurg.2010.02.086.

Outcomes of treatment of childhood achalasia.

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  • 1Division of Pediatric Surgery, University of Florida College of Medicine, PO Box 100119, Gainesville, FL 32610, USA.

Abstract

PURPOSE:

The optimal management of achalasia in children and adolescents remains unclear. The aim of this study was to review a single institution's experience with endoscopic and surgical interventions in children with achalasia.

METHODS:

A retrospective review was conducted of the medical records of children treated for achalasia from 1978 to 2008. Patient demographics and interventions were reviewed. Outcomes after procedural intervention were evaluated.

RESULTS:

Thirty-five patients with achalasia were identified, and data were available for 34 (age, 13 +/- 6 years; male, 62%). Eighteen patients underwent esophageal dilation (ED), and 16 patients underwent Heller myotomy (HM). Follow-up was available for 30 patients (ED, 15; HM, 15). There was symptom recurrence in 15 of 15 ED cases and 8 (53%) of 15 HM cases (P < .01). Additional interventions were performed in 14 (93%) of 15 ED cases and 6 (40%) of 15 HM cases (P < .01).

CONCLUSIONS:

Heller myotomy may provide more durable long-term outcomes, as defined by symptom recurrence and need for subsequent intervention, and may be considered the procedure of choice.

Copyright 2010 Elsevier Inc. All rights reserved.

PMID:
20620315
[PubMed - indexed for MEDLINE]
PMCID:
PMC4011012
Free PMC Article
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