Russian Journal of Pediatric SurgeryRussian Journal of Pediatric SurgeryДетская хирургия1560-95102412-0677Eco-Vector79110.17816/ps791Original Study ArticlesОригинальные исследованияResearch ArticlePer oral endoscopic myotomy in esophageal achalasia in children. First endoscopic proceduresПероральная эндоскопическая миотомия при ахалазии пищевода у детей. Опыт первых эндоскопических операцийhttps://orcid.org/0000-0001-6006-91127052-0205PodkamenevAlexey V.ПодкаменевАлексей Владимирович
Russian Federation

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

д-р мед. наук, доцент

podkamenev@hotmail.comhttps://orcid.org/0000-0001-5061-01399966-8125KorolevMichail P.КоролевМихаил Павлович
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

korolevmp@yandex.ruhttps://orcid.org/0000-0002-6440-23703730-7099SmirnovAlexander A.СмирновАлександр Александрович
Russian Federation

MD, Dr. Sci. (Medicine)

д-р мед. наук

smirnov-1959@yandex.ruhttps://orcid.org/0000-0003-4013-003X7482-8639FedotovLeonid E.ФедотовЛеонид Евгеньевич
Russian Federation

MD, Dr. Sci. (Medicine), Professor

д-р мед. наук, профессор

fedotov-le@yandex.ruKopyakovAlexander L.КопяковАлександр Леонидович
Russian Federation

MD

alexander_spb@mail.ruhttps://orcid.org/0000-0003-1563-30578947-9873MeshkovAlexey V.МешковАлексей Владимирович
Russian Federation

MD

alexey.v.meshkov@gmail.comhttps://orcid.org/0000-0003-0194-56748876-2938IvanovAndrey P.ИвановАндрей Петрович
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

ap.ivanov@gpmu.orghttps://orcid.org/0000-0003-3821-3805KiriltsevaMaya M.КирильцеваМайя Михайловна
Russian Federation

MD

kiriltseva@mail.ruhttps://orcid.org/0000-0001-8442-5003HodosKsenya G.ХодосКсения Геннадьевна
Russian Federation

MD

puzl_otsutstvuet@mail.ruhttps://orcid.org/0009-0002-4768-15398703-3966GlushkovaVictoria A.ГлушковаВиктория Александровна
Russian Federation

MD

pedsurgspb@yandex.ruSt. Petersburg State Pediatric Medical UniversityСанкт-Петербургский государственный педиатрический медицинский университетAcademician I.P. Pavlov First St. Petersburg State Medical UniversityПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаCity Mariinsky HospitalГородская Мариинская больница01072024130720242832532631202202417052024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, Эко-Вектор2024Eco-VectorЭко-Векторhttps://jps-nmp.ru/jour/article/view/791

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.

Обоснование. Ахалазия пищевода (АП) — поражение пищевода, в основе которого лежит нарушение его моторики. Это заболевание крайне редко встречается в детском возрасте. Среди существующих методов лечения лапароскопическая миотомия Хеллера является операцией выбора. Пероральная эндоскопическая миотомия (ПОЭМ) — эндоскопический метод лечения АП, предложенный P. Pasricha и соавт. в 2007 году.

Цель. Оценить эффективность и безопасность применения ПОЭМ у пациентов детского возраста.

Методы. Ретроспективный анализ историй болезни пациентов с подтверждённым диагнозом АП, которым выполнена ПОЭМ. Клиническая эффективность лечения оценивалась по шкале Экардта.

Результаты. С 2018 по 2021 год ПОЭМ выполнена 8 детям, средний возраст которых составил 14,4 г. Двоим детям до ПОЭМ проводилась баллонная дилатация кардии. После операции дисфагия купировалась во всех случаях без дополнительных вмешательств. После операции оценки по шкале Экардта у всех пациентов значительно снизились.

Заключение. Наши результаты подтверждают, что ПОЭМ является эффективным методом лечения АП. Однако более длительный срок наблюдения и большая группа пациентов необходимы для подтверждения роли ПОЭМ в лечении детей с АП.

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