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Treating children with achalasia using per-oral endoscopic myotomy (POEM): Twenty-one cases in review. Journal of pediatric surgery Wood, L. S., Chandler, J. M., Portelli, K. E., Taylor, J. S., Kethman, W. C., Wall, J. K. 2020

Abstract

BACKGROUND: Per-oral endoscopic myotomy (POEM), a modern treatment for achalasia, has only recently emerged as an option for pediatric patients. Here we describe and characterize the success of POEM in children with achalasia.METHODS: A single-institution prospective cohort study was performed of patients <18?years old who underwent POEM from 2014 to 2019. Main outcomes were success at one year (Eckardt =3), procedure duration, complications, reintervention.RESULTS: The median age of patients (n?=?21) was 13?years (range 2-17). Median procedure duration was 92?min (range 52-259) with case duration plateau of 87.4?min and learning rate of 15.5 cases. Intraoperative complications included capnoperitoneum requiring needle decompression and mucosotomy requiring additional clips. One patient experienced chest pain with small capnoperitoneum seen on chest radiography, and three patients had extraluminal carbon dioxide found incidentally on routine radiography. All were managed with observation. Pre- versus 1-month postprocedure Eckardt scores were significantly improved (7?±?2 versus 1?±?2, p?

View details for DOI 10.1016/j.jpedsurg.2020.02.028

View details for PubMedID 32197825