Laparoscopic Heller Myotomy with Anterior Fundoplication Ameliorates Symptoms of Achalasia in Pediatric Patients

Charles Paidas, Sarah M. Cowgill, Robert Boyle, Sam Al-Saadi, Desiree Villadolid, Alexander S. Rosemurgy

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: This study was undertaken to define outcomes after laparoscopic Heller myotomy with anterior fundoplication in pediatric patients and compare their outcomes with those in adults. Study Design: A total of 337 patients have undergone laparoscopic Heller myotomy with anterior fundoplication since 1992, and were prospectively followed; 14 were pediatric patients of median age 17 years (range 11 to 19 years). Symptoms noted by pediatric patients before and after myotomy were compared with symptoms of 56 concurrently treated adults (4 treated adults for each pediatric patient) of median age 48 years. Among many symptoms, patients scored the severity and frequency of dysphagia, chest pain, regurgitation, choking, vomiting, and heartburn before and after myotomy using a Likert scale, ranging from 0 (never/not bothersome) to 10 (always/very bothersome). Followups were 38 months, 42 months ± 33.1. Data are reported as median, mean ± SD. Results: For pediatric patients, length of stay after myotomy was 2 days, 3 days ± 2.9 versus 2 days, 2 ± 2.1 for adults. Before myotomy, symptom frequency and severity were similar between groups. After myotomy, symptom frequency and severity were similar between pediatric and adult patients, except for the frequency of chest pain. Conclusions: Achalasia can produce disabling symptoms, which were similar between pediatric and adult patients before myotomy. Laparoscopic Heller myotomy with anterior fundoplication ameliorated symptoms of achalasia in all patients, with postmyotomy symptoms similar between pediatric and adult patients. Laparoscopic Heller myotomy dramatically improved symptoms of achalasia in pediatric patients and its use is encouraged.

Original languageEnglish (US)
Pages (from-to)977-983
Number of pages7
JournalJournal of the American College of Surgeons
Volume204
Issue number5
DOIs
StatePublished - May 1 2007

All Science Journal Classification (ASJC) codes

  • Surgery

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