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

封面


如何引用文章

全文:

开放存取 开放存取
受限制的访问 ##reader.subscriptionAccessGranted##
受限制的访问 订阅或者付费存取

详细

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.

全文:

受限制的访问

作者简介

Alexey Podkamenev

St. Petersburg State Pediatric Medical University

编辑信件的主要联系方式.
Email: podkamenev@hotmail.com
ORCID iD: 0000-0001-6006-9112
SPIN 代码: 7052-0205

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

俄罗斯联邦, Saint Petersburg

Michail Korolev

St. Petersburg State Pediatric Medical University

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

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg

Alexander Smirnov

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

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

MD, Dr. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Leonid Fedotov

St. Petersburg State Pediatric Medical University; City Mariinsky Hospital

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

MD, Dr. Sci. (Medicine), Professor

俄罗斯联邦, Saint Petersburg; Saint Petersburg

Alexander Kopyakov

St. Petersburg State Pediatric Medical University

Email: alexander_spb@mail.ru

MD

俄罗斯联邦, Saint Petersburg

Alexey Meshkov

St. Petersburg State Pediatric Medical University

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

MD

俄罗斯联邦, Saint Petersburg

Andrey Ivanov

St. Petersburg State Pediatric Medical University

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

MD, Cand. Sci. (Medicine)

俄罗斯联邦, Saint Petersburg

Maya Kiriltseva

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

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

MD

俄罗斯联邦, Saint Petersburg

Ksenya Hodos

St. Petersburg State Pediatric Medical University

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

MD

俄罗斯联邦, Saint Petersburg

Victoria Glushkova

St. Petersburg State Pediatric Medical University

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

MD

俄罗斯联邦, Saint Petersburg

参考

  1. Park W, Vaezi MF. Etiology and pathogenesis of achalasia: The current understanding. Am J Gastroenterol. 2005;100(6):1404–1414. doi: 10.1111/j.1572-0241.2005.41775.x
  2. Cassella RR, Brown AL, Sayre GP, Ellis FH. Achalasia of the esophagus pathologic and etiologic considerations. Ann Surg. 1964;160(3):474–486. doi: 10.1097/00000658-196409000-00010
  3. Khajanchee YS, Van Andel R, Jobe BA, et al. Electrical stimulation of the vagus nerve restores motility in an animal model of achalasia. J Gastrointest Surg. 2003;7(7):843–849; discussion 849. EDN: WRCWTX doi: 10.1007/s11605-003-0028-6
  4. Marlais M, Fishman JR, Fell JM, et al. UK incidence of achalasia: An 11-year national epidemiological study. Arch Dis Child. 2011;96(2):192–194. doi: 10.1136/adc.2009.171975
  5. Smits M, van Lennep M, Vrijlandt R, et al. Pediatric achalasia in the Netherlands: Incidence, clinical course, and quality of life. J Pediatr. 2016;(169):110–115.e3. doi: 10.1016/j.jpeds.2015.10.057
  6. Eckardt VF, Aignherr C, Bernhard G. Predictors of outcome in patients with achalasia treated by pneumatic dilation. Gastroenterology. 1992;103(6):1732–1738. doi: 10.1016/0016-5085(92)91428-7
  7. Zaninotto G, Bennett C, Boeckxstaens G, et al. The 2018 ISDE achalasia guidelines. Dis Esophagus. 2018;31(9):doy071. doi: 10.1093/dote/doy071
  8. Franklin AL, Petrosyan M, Kane TD. Childhood achalasia: A comprehensive review of disease, diagnosis and therapeutic management. World J GastrointestEndosc. 2014;6(4):105–111. doi: 10.4253/wjge.v6.i4.105
  9. Chen WF, Li QL, Zhou PH, et al. Long-term outcomes of peroral endoscopic myotomy for achalasia in pediatric patients: A prospective, single-center study. GastrointestEndosc. 2015;81(1):91–100. doi: 10.1016/j.gie.2014.06.035
  10. Chubko DM, Razumovsky AY, MitupovZB, et al. Achalasia of cardia in children (literature review). Detskaya khirurgiya (Russian Journal of Pediatric Surgery). 2021;25(6):392–398. EDN: ICZJAF doi: 10.55308/1560-9510-2021-25-6-392-398
  11. Pasricha PJ, Hawari R, Ahmed I, et al. Submucosal endoscopic esophageal myotomy: A novel experimental approach for the treatment of achalasia. Endoscopy. 2007;39(9):761–764. doi: 10.1055/s-2007-966764
  12. Inoue HH, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42(4):265–271. doi: 10.1055/s-0029-1244080
  13. Werner YB, Hakanson B, Martinek J, et al. Endoscopic or surgical myotomy in patients with idiopathic achalasia. N Engl J Med. 2019;381(23):2219–2229. doi: 10.1056/NEJMoa1905380
  14. Razumovsky AY, Mitupov Z, Alkhasov AB, Chubko DM. Achalasia of the cardia in allgrove syndrome in an 8-year-old child. Detskaya khirurgiya (Russian Journal of Pediatric Surgery). 2021;25(2):121–126. EDN: NIFAVP doi: 10.18821/1560-9510-2021-25-2-121-126
  15. Kozlov Y, Smirnov AA, Rasputin AA, et al. Peroral endoscopic myotomy in treatment of the esophageal achalasia at children. Pediatriya: Zhurnal imeni G.N. Speranskogo. 2020;99(6):241–246. EDN: UPNJSO doi: 10.24110/0031-403X-2020-99-6-241-246
  16. Kharitonova AY, Shishin KV, Karaseva OV, et al. A case of peroral endoscopic myotomy for paediatric oesophageal achalasia. Doktor.Ru. 2021;20(3):60–65. EDN: YJLVWA doi: 10.31550/17272378-2021-20-3-60-65
  17. Petrosyan M, Mostammand S, Shah AA, et al. Per oral endoscopic myotomy (POEM) for pediatric achalasia: Institutional experience and outcomes. J Pediatr Surg. 2022;57(11):728–735. EDN: DRDNYH doi: 10.1016/j.jpedsurg.2022.02.017
  18. Saez J, Mejia R, Pattillo JC, et al. Per oral endoscopic myotomy (POEM) in pediatric patients with esophageal achalasia: First Latin-American experience. J Pediatr Surg. 2021;56(4):706–710. doi: 10.1016/j.jpedsurg.2020.06.007
  19. Korolev MP, Fedotov LE, Ogloblin AL, et al. Russia’s first poem in the treatment of achalasia in children. Pediatrician. 2017;8(2):94–98. EDN: YPSABL doi: 10.17816/PED8294-98
  20. Miao S, Wu J, Lu J, et al. Peroral endoscopic myotomy in children with achalasia: A relatively long-term single-center study. J Pediatr Gastroenterol Nutr. 2018;66(2):257–262. doi: 10.1097/MPG.0000000000001675
  21. Wood LS, Chandler JM, Portelli KE, et al. Treating children with achalasia using per-oral endoscopic myotomy (POEM): Twenty-one cases in review. J Pediatr Surg. 2020;55(6):1006–1012. doi: 10.1016/j.jpedsurg.2020.02.028
  22. Nabi Z, Ramchandani M, Chavan R, et al. Outcome of peroral endoscopic myotomy in children with achalasia. Surg Endosc. 2019;33(11):3656–3664. EDN: DGPNNX doi: 10.1007/s00464-018-06654-1
  23. Lee Y, Brar K, Doumouras AG, Hong D. Peroral endoscopic myotomy (POEM) for the treatment of pediatric achalasia: A systematic review and meta-analysis. Surg Endosc. 2019;33(6):1710–1720. EDN: VHIRLA doi: 10.1007/s00464-019-06701-5
  24. Goneidy A, Cory-Wright J, Zhu L, Malakounides G. Surgical management of esophageal achalasia in pediatrics: A systematic review. Eur J Pediatr Surg. 2020;30(01):013–020. doi: 10.1055/s-0039-1697958
  25. Nabi Z, Talukdar R, Chavan R, et al. Outcomes of per-oral endoscopic myotomy in children: A systematic review and meta-analysis. Dysphagia. 2022;37(6):1468–1481. EDN: JGIPHA doi: 10.1007/s00455-022-10409-5
  26. Tan Y, Zhu H, Li C, et al. Comparison of peroral endoscopic myotomy and endoscopic balloon dilation for primary treatment of pediatric achalasia. J Pediatr Surg. 2016;51(10):1613–1618. doi: 10.1016/j.jpedsurg.2016.06.008
  27. Ponds FA, Fockens P, Lei A, et al. Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: A randomized clinical trial. JAMA. 2019;322(2):134–144. doi: 10.1001/jama.2019.8859
  28. Askegard-Giesmann JR, Grams JM, Hanna AM, et al. Minimally invasive Heller’s myotomy in children: Safe and effective. J Pediatr Surg. 2009;44(5):909–911. doi: 10.1016/j.jpedsurg.2009.01.022
  29. Corda L, Pacilli M, Clarke S, et al. Laparoscopic oesophagealcardiomyotomy without fundoplication in children with achalasia: A 10-year experience. SurgEndosc. 2010;24(1):40–44. doi: 10.1007/s00464-009-0513-4
  30. Pandian TK. Laparoscopic esophagomyotomy for achalasia in children: A review. World J Gastrointest Endosc. 2016;8(2):56. doi: 10.4253/wjge.v8.i2.56
  31. Morera C, Nurko S. Heterogeneity of lower esophageal sphincter function in children with achalasia. J Pediatr Gastroenterol Nutr. 2012;54(1):34–40. doi: 10.1097/MPG.0b013e3182293d8c
  32. Zhong C, Tan S, Huang S, et al. Clinical outcomes of peroral endoscopic myotomy for achalasia in children: A systematic review and meta-analysis. Dis Esophagus. 2021;34(4):doaa112. doi: 10.1093/dote/doaa112
  33. Nabi Z, Reddy DN, Ramchandani M. Adverse events during and after per-oral endoscopic myotomy: Prevention, diagnosis, and management. Gastrointestinal Endoscopy. 2018;87(1):4–17. doi: 10.1016/j.gie.2017.09.029
  34. Richards WO, Torquati A, Holzman MD, et al. Heller myotomy versus heller myotomy with dor fundoplication for achalasia. Ann Surg. 2004;240(3):405–415. doi: 10.1097/01.sla.0000136940.32255.51
  35. Broman KK, Phillips SE, Faqih A, et al. Heller myotomy versus Heller myotomy with dor fundoplication for achalasia: Long-term symptomatic follow-up of a prospective randomized controlled trial. Surg Endosc. 2018;32(4):1668–1674. EDN: AMDKJB doi: 10.1007/s00464-017-5845-x
  36. Carlson DA, Pandolfino JE. High-resolution manometry in clinical practice. Gastroenterol Hepatol (NY). 2015;11(6):374–384.
  37. Pandolfino JE, Kwiatek MA, Nealis T, et al. Achalasia: A new clinically relevant classification by high-resolution manometry. Gastroenterol. 2008;135(5):1526–1533. doi: 10.1053/j.gastro.2008.07.022
  38. Yadlapati R, Kahrilas PJ, Fox MR, et al. Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0. Neurogastroenterology Motil. 2021;33(1):e14058. doi: 10.1111/nmo.14058
  39. Ivashkin VT, Trukhmanov AS, Gogello EA, et al. Diagnostics and treatment of cardiac achalasia and cardiospasm: guidelines of the Russian gastroenterological association. Russ J Gastroenterol Hepatol Coloproctol. 2016;26(4):36–54. EDN: YHTFVX doi: 10.22416/1382-4376-2016-26-4-36-54

补充文件

附件文件
动作
1. JATS XML
下载
2. Fig. 1. Esophagogastroduodenoscopy: esophagitis and narrowing of esophagus.

下载 (85KB)
索引源数据
3. Fig. 2. Preoperative esophagogram, showing dilating esophagus and “Beak sign”.

下载 (202KB)
索引源数据
4. Fig. 3. Peroral endoscopic myotomy: creating of submucosal tunnel.

下载 (148KB)
索引源数据
5. Fig. 4. Peroral endoscopic myotomy: performing a myotomy.

下载 (119KB)
索引源数据
6. Fig. 5. Eckardt score: ПОЭМ — peroral endoscopic myotomy.

下载 (133KB)
索引源数据

版权所有 © Eco-Vector, 2024

##common.cookie##