Per oral endoscopic myotomy in esophageal achalasia in children. First endoscopic procedures

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Abstract

BACKGROUND: Achalasia is an esophagus lesion which is characterized by disorders of its motility. It is met extremely rare in childhood. Among the existing techniques of achalasia management, Heller's laparoscopic myotomy is a procedure of choice. Peroral endoscopic myotomy (POEM) is an endoscopic method for AP treating proposed by P. Pasricha in 2007.

AIM: To describe the experience of per oral endoscopic myotomy in children.

METHODS: The authors performed a retrospective analysis of data taken from the patients with confirmed esophageal achalasia who had had POEM. Clinical efficacy was assessed using the Eckard scale.

RESULTS: In 2018–2021, 8 children with average age 14.4 years were treated with POEM surgery. Before POEM, 2 children underwent balloon dilatation of the cardia. The surgery was technically performed in all children. Dysphagia was eliminated in all patients, and none of them required any additional intervention. A significant decrease in Eckard scale scores was registered in all children after surgery.

CONCLUSION: Our results confirm findings that POEM is an effective procedure for treating esophageal achalasia. However, a longer follow-up period and a larger group of patients are needed to confirm POEM role in the management of children with esophageal achalasia.

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About the authors

Alexey V. Podkamenev

St. Petersburg State Pediatric Medical University

Author for correspondence.
Email: podkamenev@hotmail.com
ORCID iD: 0000-0001-6006-9112
SPIN-code: 7052-0205

MD, Dr. Sci. (Medicine), Associate Professor

Россия, Saint Petersburg

Michail P. Korolev

St. Petersburg State Pediatric Medical University

Email: korolevmp@yandex.ru
ORCID iD: 0000-0001-5061-0139
SPIN-code: 9966-8125

MD, Dr. Sci. (Medicine), Professor

Россия, Saint Petersburg

Alexander A. Smirnov

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: smirnov-1959@yandex.ru
ORCID iD: 0000-0002-6440-2370
SPIN-code: 3730-7099

MD, Dr. Sci. (Medicine)

Россия, Saint Petersburg

Leonid E. Fedotov

St. Petersburg State Pediatric Medical University; City Mariinsky Hospital

Email: fedotov-le@yandex.ru
ORCID iD: 0000-0003-4013-003X
SPIN-code: 7482-8639

MD, Dr. Sci. (Medicine), Professor

Россия, Saint Petersburg; Saint Petersburg

Alexander L. Kopyakov

St. Petersburg State Pediatric Medical University

Email: alexander_spb@mail.ru

MD

Россия, Saint Petersburg

Alexey V. Meshkov

St. Petersburg State Pediatric Medical University

Email: alexey.v.meshkov@gmail.com
ORCID iD: 0000-0003-1563-3057
SPIN-code: 8947-9873

MD

Россия, Saint Petersburg

Andrey P. Ivanov

St. Petersburg State Pediatric Medical University

Email: ap.ivanov@gpmu.org
ORCID iD: 0000-0003-0194-5674
SPIN-code: 8876-2938

MD, Cand. Sci. (Medicine)

Россия, Saint Petersburg

Maya M. Kiriltseva

Academician I.P. Pavlov First St. Petersburg State Medical University

Email: kiriltseva@mail.ru
ORCID iD: 0000-0003-3821-3805

MD

Россия, Saint Petersburg

Ksenya G. Hodos

St. Petersburg State Pediatric Medical University

Email: puzl_otsutstvuet@mail.ru
ORCID iD: 0000-0001-8442-5003

MD

Россия, Saint Petersburg

Victoria A. Glushkova

St. Petersburg State Pediatric Medical University

Email: pedsurgspb@yandex.ru
ORCID iD: 0009-0002-4768-1539
SPIN-code: 8703-3966

MD

Россия, Saint Petersburg

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Supplementary files

Supplementary Files
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1. JATS XML
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2. Fig. 1. Esophagogastroduodenoscopy: esophagitis and narrowing of esophagus.

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3. Fig. 2. Preoperative esophagogram, showing dilating esophagus and “Beak sign”.

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4. Fig. 3. Peroral endoscopic myotomy: creating of submucosal tunnel.

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5. Fig. 4. Peroral endoscopic myotomy: performing a myotomy.

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6. Fig. 5. Eckardt score: ПОЭМ — peroral endoscopic myotomy.

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