Abstract
Peroral endoscopic myotomy (POEM) has been developed to provide a less-invasive myotomy for achalasia in adults but seldom has been used in pediatric patients. To evaluate the feasibility, safety, and efficacy of POEM for pediatric patients with achalasia. Single-center, prospective study. Academic medical center. A total of 27 pediatric patients (mean age 13.8 years, range 6-17 years) with achalasia. The primary outcome was symptom relief during follow-up, defined as an Eckardt score of≤3. Secondary outcomes were procedure-related adverse events, clinical reflux adverse events, and lower esophageal sphincter (LES) pressure on manometry before and after POEM. A total of 26 cases (96.3%) underwent successful POEM. A submucosal tunnelling attempt failed in 1 case because of serious inflammation and adhesion. No serious adverse events related to POEM were encountered. During a mean follow-up period of 24.6 months (range 15-38 months), treatment success was achieved in all patients (mean score before vs after treatment 8.3 vs 0.7; P< .001). Mean LES pressure also decreased from a mean of 31.6mm Hg to 12.9mm Hg after POEM (P< .001). Five patients developed clinical reflux adverse events (19.2%). Single center and lack of some objective evaluations. This relatively long-term follow-up study adds to the evidence that POEM seems to be a promising new treatment for pediatric patients with achalasia, resulting in long-term symptom relief in all cases and without serious adverse events.
Published Version
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