JOURNAL ARTICLE

Long-term outcomes of peroral endoscopic myotomy for achalasia in pediatric patients: a prospective, single-center study

Wei-Feng Chen, Quan-Lin Li, Ping-Hong Zhou, Li-Qing Yao, Mei-Dong Xu, Yi-Qun Zhang, Yun-Shi Zhong, Li-Li Ma, Wen-Zheng Qin, Jian-Wei Hu, Ming-Yan Cai, Meng-Jiang He, Zhao Cui
Gastrointestinal Endoscopy 2015, 81 (1): 91-100
25088923

BACKGROUND: Peroral endoscopic myotomy (POEM) has been developed to provide a less-invasive myotomy for achalasia in adults but seldom has been used in pediatric patients.

OBJECTIVE: To evaluate the feasibility, safety, and efficacy of POEM for pediatric patients with achalasia.

DESIGN: Single-center, prospective study.

SETTING: Academic medical center.

PATIENTS: A total of 27 pediatric patients (mean age 13.8 years, range 6-17 years) with achalasia.

INTERVENTIONS POEM MAIN OUTCOME MEASUREMENTS: The primary outcome was symptom relief during follow-up, defined as an Eckardt score of ≤3. Secondary outcomes were procedure-related adverse events, clinical reflux adverse events, and lower esophageal sphincter (LES) pressure on manometry before and after POEM.

RESULTS: A total of 26 cases (96.3%) underwent successful POEM. A submucosal tunnelling attempt failed in 1 case because of serious inflammation and adhesion. No serious adverse events related to POEM were encountered. During a mean follow-up period of 24.6 months (range 15-38 months), treatment success was achieved in all patients (mean score before vs after treatment 8.3 vs 0.7; P < .001). Mean LES pressure also decreased from a mean of 31.6 mm Hg to 12.9 mm Hg after POEM (P < .001). Five patients developed clinical reflux adverse events (19.2%).

LIMITATIONS: Single center and lack of some objective evaluations.

CONCLUSION: This relatively long-term follow-up study adds to the evidence that POEM seems to be a promising new treatment for pediatric patients with achalasia, resulting in long-term symptom relief in all cases and without serious adverse events.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
25088923
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"