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. 2025 Jun;95(6):1142-1146.
doi: 10.1111/ans.70091. Epub 2025 May 5.

Paediatric achalasia - what is different?

Ines Teixeira  1 , Catarina Lima  2 , Tiago Tuna  3 , Leonor Carmo  3 , Miguel Campos  3
Affiliations

Paediatric achalasia - what is different?

Ines Teixeira et al. ANZ J Surg. 2025 Jun.

Abstract

Background: Achalasia is a rare condition characterized by disturbed oesophageal motility. Therapeutic control of symptoms is difficult to achieve, and no curative approach is available. Laparoscopic Heller myotomy (LHM) is the treatment of choice for achalasia. We describe our experience in paediatric patients with achalasia treated at a tertiary paediatric surgery center.

Methods: A retrospective longitudinal cohort study was conducted in paediatric patients diagnosed with achalasia in a tertiary paediatric surgery center from 2005 to 2022.

Results: Sixteen patients with achalasia were selected; 13 were males (81.2%) and the mean age was 11.6(±2.16) years. The most common presentation of the disease was solid dysphagia (93.8%). Timed esophagogram was performed in 15 patients (93.8%), manometry was conducted in 12 patients (75%) and all patients were submitted to upper endoscopy. All patients were submitted to LHM with Dor fundoplicature. All patients had postoperative relief of symptoms in the immediate postoperative period. The median postoperative follow-up time was 4 (0.6-11) years. Two patients (12.5%) needed endoscopic dilatation due to relapsed symptoms. Three patients (18.8%) suffered from gastroesophageal reflux disease (GERD). No patient needed re-operation for achalasia.

Conclusion: LHM is safe and effective in the symptomatic relief of achalasia in paediatric patients. Nonetheless, there is no proved curative treatment for achalasia. Close follow-up is essential for disease control in the long term.

Keywords: achalasia; laparoscopic myotomy; paediatric.

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