European J Pediatr Surg Rep. 2015; 03(01): 018-022
DOI: 10.1055/s-0034-1372461
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Peroral Endoscopic Myotomy for the Treatment of Achalasia in a 10-Year-Old Male Patient

Jörg Filser
1   Department of General, Visceral, Vascular and Paediatric Surgery, University Medical Center, Würzburg, Germany
,
Anke Dick
2   University Children's Hospital, University Medical Center, Würzburg, Germany
,
Thomas Meyer
1   Department of General, Visceral, Vascular and Paediatric Surgery, University Medical Center, Würzburg, Germany
,
Christoph-Thomas Germer
1   Department of General, Visceral, Vascular and Paediatric Surgery, University Medical Center, Würzburg, Germany
,
Burkard H.A. von Rahden
1   Department of General, Visceral, Vascular and Paediatric Surgery, University Medical Center, Würzburg, Germany
› Author Affiliations
Further Information

Publication History

06 November 2013

26 January 2014

Publication Date:
17 July 2014 (online)

Abstract

Peroral endoscopic myotomy (POEM) is a new endoscopic treatment for achalasia with very good short-term results in adults. Data about POEM in pediatric patients are missing. We present the case of a 10-year-old male patient with type I (classic) achalasia, successfully treated with POEM. The procedure was accomplished in a similar fashion to the technique used in adults. Short-term results were fine, with a complete control of dysphagia and absence of reflux. We suggest that POEM is a suitable option in pediatric patients—similar to adults—but long-term results must be awaited.

 
  • References

  • 1 Mayberry JF. Epidemiology and demographics of achalasia. Gastrointest Endosc Clin N Am 2001; 11 (2) 235-248 , v
  • 2 Hussain SZ, Thomas R, Tolia V. A review of achalasia in 33 children. Dig Dis Sci 2002; 47 (11) 2538-2543
  • 3 Di Nardo G, Rossi P, Oliva S , et al. Pneumatic balloon dilation in pediatric achalasia: efficacy and factors predicting outcome at a single tertiary pediatric gastroenterology center. Gastrointest Endosc 2012; 76 (5) 927-932
  • 4 Lee CW, Kays DW, Chen MK, Islam S. Outcomes of treatment of childhood achalasia. J Pediatr Surg 2010; 45 (6) 1173-1177
  • 5 Inoue H, Minami H, Kobayashi Y , et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy 2010; 42 (4) 265-271
  • 6 Stavropoulos SN, Modayil RJ, Friedel D, Savides T. The International Per Oral Endoscopic Myotomy Survey (IPOEMS): a snapshot of the global POEM experience. Surg Endosc 2013; 27 (9) 3322-3338
  • 7 Swanstrom LL, Kurian A, Dunst CM, Sharata A, Bhayani N, Rieder E. Long-term outcomes of an endoscopic myotomy for achalasia: the POEM procedure. Ann Surg 2012; 256 (4) 659-667
  • 8 Bredenoord AJ, Fox M, Kahrilas PJ, Pandolfino JE, Schwizer W, Smout AJ. International High Resolution Manometry Working Group. Chicago classification criteria of esophageal motility disorders defined in high resolution esophageal pressure topography. Neurogastroenterol Motil 2012; 24 (Suppl. 01) 57-65
  • 9 Eckardt VF. Clinical presentations and complications of achalasia. Gastrointest Endosc Clin N Am 2001; 11 (2) 281-292 , vi
  • 10 Swanstrom LL. Poetry is in the air: first multi-institutional results of the per-oral endoscopic myotomy procedure for achalasia. Gastroenterology 2013; 145 (2) 272-273
  • 11 Maselli R, Inoue H, Misawa M , et al. Peroral endoscopic myotomy (POEM) in a 3-year-old girl with severe growth retardation, achalasia, and Down syndrome. Endoscopy 2012; 44 (2, Suppl 2 UCTN) E285-E287
  • 12 Familiari P, Marchese M, Gigante G , et al. Peroral endoscopic myotomy for the treatment of achalasia in children. J Pediatr Gastroenterol Nutr 2013; 57 (6) 794-797
  • 13 Shiwaku H, Inoue H, Beppu R , et al. Successful treatment of diffuse esophageal spasm by peroral endoscopic myotomy. Gastrointest Endosc 2013; 77 (1) 149-150
  • 14 Sharata A, Kurian AA, Dunst CM, Bhayani NH, Reavis KM, Swanström LL. Peroral endoscopic myotomy (POEM) is safe and effective in the setting of prior endoscopic intervention. J Gastrointest Surg 2013; 17 (7) 1188-1192
  • 15 Zhou PH, Li QL, Yao LQ , et al. Peroral endoscopic remyotomy for failed Heller myotomy: a prospective single-center study. Endoscopy 2013; 45 (3) 161-166
  • 16 Richards WO, Torquati A, Holzman MD , et al. Heller myotomy versus Heller myotomy with Dor fundoplication for achalasia: a prospective randomized double-blind clinical trial. Ann Surg 2004; 240 (3) 405-412 , discussion 412–415
  • 17 Campos GM, Vittinghoff E, Rabl C , et al. Endoscopic and surgical treatments for achalasia: a systematic review and meta-analysis. Ann Surg 2009; 249 (1) 45-57
  • 18 Boeckxstaens GE, Annese V, des Varannes SB , et al; European Achalasia Trial Investigators. Pneumatic dilation versus laparoscopic Heller's myotomy for idiopathic achalasia. N Engl J Med 2011; 364 (19) 1807-1816
  • 19 Li QL, Chen WF, Zhou PH , et al. Peroral endoscopic myotomy for the treatment of achalasia: a clinical comparative study of endoscopic full-thickness and circular muscle myotomy. J Am Coll Surg 2013; 217 (3) 442-451
  • 20 Ren Z, Zhong Y, Zhou P , et al. Perioperative management and treatment for complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA) (data from 119 cases). Surg Endosc 2012; 26 (11) 3267-3272
  • 21 Von Renteln D, Fuchs KH, Fockens P , et al. Peroral endoscopic myotomy for the treatment of achalasia: an international prospective multicenter study. Gastroenterology 2013; 145 (2) 309-311 , e1–e3
  • 22 Li QL, Zhou PH, Yao LQ , et al. Early diagnosis and management of delayed bleeding in the submucosal tunnel after peroral endoscopic myotomy for achalasia (with video). Gastrointest Endosc 2013; 78 (2) 370-374
  • 23 Onimaru M, Inoue H, Ikeda H , et al. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study. J Am Coll Surg 2013; 217 (4) 598-605