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Results of the laparoscopic Heller-Dor procedure for pediatric esophageal achalasia
Authors:Mattioli G  Esposito C  Pini Prato A  Doldo P  Castagnetti M  Barabino A  Gandullia P  Staiano A M  Settimi A  Cucchiara S  Montobbio G  Jasonni V
Affiliation:(1) Pediatric Surgery, Gaslini Research Institute, University of Genova, Largo G. Gaslini, 5, 16100 Genova, Italy;(2) Pediatric Surgery, University of Catanzaro "ldquo"Magna Graecia and University of Naples "ldquo"Federico II,"rdquo" Via Pansini 5, 80131, Naples, Italy;(3) Pediatric Gastroenterology, Gaslini Research Institute, Largo G. Gaslini, 5, 16100 Genova, Italy;(4) Pediatric Anesthesiology, Gaslini Research Institute, Largo G. Gaslini, 5, 16100 Genova, Italy
Abstract:Background: Esophageal achalasia is not a frequent disorder in children and different treatments have been proposed during past decades. This study reviews the results of the laparoscopic Heller-Dor procedure performed in pediatric patients in two different surgical units. Methods: We included the patients aged <14 years with a minimum follow-up of 6 months operated on in the period 1994–2001. A single longitudinal anterior esophageal myotomy (Heller) and a 180° anterior gastropexy (Dor) were laparoscopically performed. The patients were checked to detect intra- or postoperative complications and recurrence. Results: Twenty children were operated on. Mean follow-up was 45 months (range 6–102). Postoperative clinical score was Visick 1 in 15 cases and Visick 2 in five. Conclusions: As complication and recurrence rates are very low we consider modified Heller myotomy and Dor gastropexy through a laparoscopic approach our first choice to treat esophageal achalasia in the pediatric population.
Keywords:Esophagus  Achalasia  Laparoscopy  Children
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