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Comparative Study
. 2010 Jun;45(6):1173-7.
doi: 10.1016/j.jpedsurg.2010.02.086.

Outcomes of treatment of childhood achalasia

Constance W Lee  1 , David W Kays, Mike K Chen, Saleem Islam
Affiliations
Comparative Study

Outcomes of treatment of childhood achalasia

Constance W Lee et al. J Pediatr Surg. 2010 Jun.

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.

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