Clinical analysis of laparoscopic Heller and POEM in the treatment of pediatric achalasia of cardia

doi:10.3877/cma.j.issn.2095-8765.2020.02.004

Abstract

Abstract:

Objective

Analysis of feasibility and safety of laparoscopic Heller and POEM in the treatment of pediatric achalasia of cardia.

Methods

The clinical data of 10 cases of pediatric achalasia of cardia admitted to Qilu Hospital (Qingdao), Cheeloo College of Medicine, Shandong University from June 2014 to June 2018 were analyzed retrospectively. Among them, there were 6 boys and 4 girls, with an average age of 4.5±2.3 years. Collect and record the patient's history, operation mode, complications and follow-up results. The measurement data is expressed by mean ± standard deviation.

Results

All the 10 cases were underwent surgical treatment. Among them, laparoscopic Heller operation was performed in 7 cases and POEM in 3 cases. One case with congenital history of esophageal atresia had rupture of mucous membrane during operation, and esophageal thoracic fistula occurred after operation, and the fistula closed after 2 months by using drainage of thoracic cavity and antibiotic treatment. The average operation time of laparoscopic Heller group was 84.2±15.2 minutes, while that of POEM group was 67±4.8 minutes. No esophageal stricture and gastroesophageal reflux were found in all the cases after follow-up for 9 months to 4 years.

Conclusions

Laparoscopic Heller and POEM can be used in the treatment of pediatric achalasia of cardia. The curative effect is accurate and the complications can be controlled. POEM have some advantages in terms of operation time and blood loss, but the appropriate surgical scheme should be selected according to the condition and clinical conditions of the children.

Key words: Laparoscopic Heller Myotomy, POEM, Children, Achalasia of cardia

Chao Liu, Lei Zhang, Xiang Li, Hao Sun, Qi Zhou, Chao. Sun. Clinical analysis of laparoscopic Heller and POEM in the treatment of pediatric achalasia of cardia[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2020, 07(02): 88-92.

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References 26

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评分	症状
评分	体重减轻（Kg）	吞咽困难	胸骨后疼痛	反流
0	无	无	无	无
1	＜5	偶尔	偶尔	偶尔
2	5~10	每天	每天	每天
3	＞10	每餐	每餐	每餐

评分	症状
评分	体重减轻（Kg）	吞咽困难	胸骨后疼痛	反流
0	无	无	无	无
1	＜5	偶尔	偶尔	偶尔
2	5~10	每天	每天	每天
3	＞10	每餐	每餐	每餐

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