Laparoscopic esophagomyotomy for achalasia in children： Areview

• 作者: Aodhnait S Fahy Arman Arghami Christopher R Moir David R Farley Michael B Ishitani Nimesh D Naik T Kumar Pandian
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: ACHALASIA Esophagomyotomy LAPAROSCOPY HELLER MYOTOMY OUTCOMES
• 年，卷（期）: 2016,（2）
• 页码范围: 56-66
• 页数: 11页
• 分类号: R

摘要

Esophageal achalasia in children is rare but ultimatelyrequires endoscopic or surgical treatment. Historically,Heller esophagomyotomy has been recommended as thetreatment of choice. The refinement of minimally invasivetechniques has shifted the trend of treatment towardlaparoscopic Heller myotomy （LHM） in adults and childrenwith achalasia. A review of the available literature on LHMperformed in patients 〈 18 years of age was conducted.The pediatric LHM experience is limited to one multiinstitutionaland several single-institutional retrospectivestudies. Available data suggest that LHM is safe andeffective. There is a paucity of evidence on the need forand superiority of concurrent antireflux procedures. Inaddition, a more complete portrayal of complications andlong-term （〉 5 years） outcomes is needed. Due to theinfrequency of achalasia in children, these characteristicsare unlikely to be defined without collaboration betweenmultiple pediatric surgery centers. The introduction ofperoral endoscopic myotomy and single-incision techniques,continue the trend of innovative approaches that mayeventually become the standard of care.