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Laparoscopic Heller Myotomy with Anterior Fundoplication Ameliorates Symptoms of Achalasia in Pediatric Patients
- Source :
- Journal of the American College of Surgeons. 204:977-983
- Publication Year :
- 2007
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2007.
-
Abstract
- Background This study was undertaken to define outcomes after laparoscopic Heller myotomy with anterior fundoplication in pediatric patients and compare their outcomes with those in adults. Study Design A total of 337 patients have undergone laparoscopic Heller myotomy with anterior fundoplication since 1992, and were prospectively followed; 14 were pediatric patients of median age 17 years (range 11 to 19 years). Symptoms noted by pediatric patients before and after myotomy were compared with symptoms of 56 concurrently treated adults (4 treated adults for each pediatric patient) of median age 48 years. Among many symptoms, patients scored the severity and frequency of dysphagia, chest pain, regurgitation, choking, vomiting, and heartburn before and after myotomy using a Likert scale, ranging from 0 (never/not bothersome) to 10 (always/very bothersome). Followups were 38 months, 42 months±33.1. Data are reported as median, mean ± SD. Results For pediatric patients, length of stay after myotomy was 2 days, 3 days±2.9 versus 2 days, 2±2.1 for adults. Before myotomy, symptom frequency and severity were similar between groups. After myotomy, symptom frequency and severity were similar between pediatric and adult patients, except for the frequency of chest pain. Conclusions Achalasia can produce disabling symptoms, which were similar between pediatric and adult patients before myotomy. Laparoscopic Heller myotomy with anterior fundoplication ameliorated symptoms of achalasia in all patients, with postmyotomy symptoms similar between pediatric and adult patients. Laparoscopic Heller myotomy dramatically improved symptoms of achalasia in pediatric patients and its use is encouraged.
- Subjects :
- Adult
Male
Myotomy
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Fundoplication
Achalasia
Chest pain
Statistics, Nonparametric
Humans
Medicine
Child
Laparoscopy
medicine.diagnostic_test
business.industry
Heartburn
Length of Stay
Middle Aged
medicine.disease
Dysphagia
Surgery
Endoscopy
Esophageal Achalasia
Treatment Outcome
Anesthesia
Vomiting
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 10727515
- Volume :
- 204
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Surgeons
- Accession number :
- edsair.doi.dedup.....01129e365956683d8fc19beb99997822
- Full Text :
- https://doi.org/10.1016/j.jamcollsurg.2006.12.046