Laparoscopic surgery for cardia achalasia in children

doi:10.3877/cma.j.issn.2095-8765.2019.02.004

Abstract

Abstract:

Objective

To investigate the advantages and safety of laparoscopic treatment of children with cardia achalasia.

Methods

A retrospective analysis of 28 patients with achalasia who were admitted to our group (Xinjiang Uygur Autonomous Region People's Hospital Pediatric Surgery, Xinjiang Uygur Autonomous Children's Hospital Pediatric Surgery, Capital Pediatrics Institute Children's Hospital Pediatric Surgery) from December 2008 to December 2018. All patients successfully underwent laparoscopic Heller+ fundoplication. Summarize the diagnosis and treatment process of children, surgical methods, surgical safety, and postoperative complications.

Results

The average time for laparoscopic surgery in children with achalasia was (85.0±3.5) minutes. The average intraoperative blood loss was (8.0±1.3) ml. After one week of observation, one case had a leakage after intraoperative repair of mucosal rupture, and left the stomach tube to heal after one month. After 1 year of follow-up, no recurrence was observed, nutrition was improved, quality of life was improved, and family members were satisfied.

Conclusion

Laparoscopic treatment of children with achalasia has the advantages of less damage, fewer complications, good postoperative recovery, and safety. Laparoscopy has great application value in the treatment of children with achalasia.

Key words: Cardia achalasia, Child, Laparoscopes

Ling Zhou, Yanfang Liu, Kai Li, Jun He, Long Li, Jinghao Yan, Shuixue Li. Laparoscopic surgery for cardia achalasia in children[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2019, 06(02): 66-69.

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References 21

1	吴在德．外科学[M]. 7版．北京：人民卫生出版社, 2008: 355.
2	赵作成.贲门失弛缓症治疗进展[J]．医学综述, 2013, 19(13): 2403, 2405.
3	Goyal RK, Chaudhary A. Pathogeuesis of achalasia: lessons form mutantmice [J]. Gastroenterology, 2010, 139(4): 1086-1090．
4	Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotoroy (POEM) for esophageal achalasia [J]. Endoscopy, 2010, 42(4): 265-271.
5	Von Renteln D, Inoue H, Minami H, et al. Peroral endoscopic myotomy for the treatment of achalasia: a prospective single center study [J]. Am J Gastroenterol, 2012, 107: 411-417.
6	张爱梅，刘霞．球囊扩张和Heller肌切开治疗儿童贲门失弛缓症的疗效和安全性的Meta分析[J]．中国询证儿科杂志, 2012, 7(4): 269-273．
7	Lemmer JH，Coran AG, Wesley JR. et a1. Achalasia in. ehil-dren: treatment by anterior esophageal myotomy (modified Heller operation) [J]. J Pediatr Surg, 1985, 20(4): 333-338．
8	Ballantine TV. Fitzgerald JF. Grosfeld JL. Transabdominal esophagomyotomy for achalasia in children [J]. J Pediatr surg, 1980, 15(4): 457-461.
9	Holcomb GW 3rd, Riehards WO, Riedel BD. Laparoscopie esophagomyotomy for achalasia in children [J]. J Pediatr surg, 1996, 31(5): 716-718．
10	周莹，王雯，吴晔明．腹腔镜Heller's术治疗儿童贲门失弛缓症[J]．中华小儿外科杂志, 2016, 37(11): 828-831.
11	Bell RC. Laparoscopic closure of esophageal perforation following pneumatic dilation for achalasia. Report of two cases [J]. Surg Endosc, 1997, 11: 476.
12	Kung AH. Heller's cardiomyotomy with augmented Toupet'S fundopl ication immediate and longterm outcome [J]. J Med Assoc Thai, 2010, 93(12): 13851390.
13	Hurez BJ. Endoscopic and surgical treatments for achalasia a systematic review and meta analysis [J]. Ann Surg, 2009, 249(1): 4557.
14	张葆勋，伍冀湘，蒋俭. 3D腹腔镜联合胃镜手术治疗贲门失弛缓症疗效分析[J]．河北医药, 2017, 38(8): 1205-1208.
15	周峻，李龙，李索林．开放和腹腔镜手术治疗儿童贲门失弛缓症疗效的初步比较[J]．中华小儿外科杂志, 2010, 31(12): 888-892.
16	Silecchia G, Casella G, Recchia CL, et al. Laparoscopic Transhiatal Treatment of Large Epiphrenic Esophageal Diverticulum [J]. JSLS,2008, 12(45): 104-108.
17	Cowgill SM, Villadolid D, Boyle R, et al. Laparo-scopic Heller myotomy for achalasia: results after 10 years [J]. Surg Endosc, 2009, 23(12): 2644-2649.
18	Mineo TC, Pompeo E. Long-term outcome of Heller myotomy in achalasic sigmoid esophagus. J Thorac Cardiovasc Surg, 2004, 128(3): 402-407.
19	Youssef Y, Richards WO, Sharp K, et al. Relief of Dysphagia after Laparoscopic Heller Myotomy Improves Long-Term Quality of Life [J]. J Gastrointest Surg, 2007, 11(3): 309-313.
20	Schier F, Moutupet P, Esposito C. Laparopic ingunal hemiorrphy in children: a three center experience with 933 repairs [J]. J Pediatr Surg, 2002, 71(3): 395-397.
21	周玲，李凯，和军．腹腔镜治疗小儿贲门失弛缓症20例[J/CD]．中华疝和腹壁外科杂志（电子版）, 2014, 8(5): 439-440.

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