Complications of laparoscopic treatment of esophageal achalasia in children

• Published in: Journal of pediatric surgery Vol. 35; no. 5; pp. 680 - 683
• Main Authors: Esposito, Ciro, Mendoza-Sagaon, Mario, Roblot-Maigret, Blandine, Amici, Giuseppe, Desruelle, Patrice, Montupet, Philippe
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-05-2000; Elsevier
• Subjects: Adolescent; Biological and medical sciences; Child; Child, Preschool; Deglutition Disorders - epidemiology; Deglutition Disorders - etiology; Esophageal achalasia; Esophageal Achalasia - surgery; Esophageal Perforation - epidemiology; Esophageal Perforation - etiology; Esophagus; Female; Follow-Up Studies; Heller's esophagocardiomyotomy; Humans; Incidence; laparoscopy; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Medical sciences; Postoperative Care; Postoperative Complications - epidemiology; Risk Factors; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; laparoscopy; Heller's esophagocardiomyotomy; Esophageal achalasia; Human; Iatrogenic; Treatment efficiency; Esophageal disease; Laparoscopic surgery; Congenital disease; Esophagus; Treatment; Heller operation; Malformation; Surgery; Adolescent; Digestive diseases; Achalasia; Complication; Child
• DOI: 10.1053/jpsu.2000.5942
• EISSN: 1531-5037
• ISSN: 0022-3468

Background/Purpose: The aim of this study was to evaluate the incidence and management of the complications that occurred in some children who underwent laparoscopic Heller's esophagocardiomyotomy in the authors' institutions. Methods: Between March 1993 and October 1998, the files of all the children with achalasia who underwent laparoscopic Heller's esophagocardiomyotomy in a community hospital in Naples, Italy, and a private hospital in Paris, France, were reviewed. A 5-port technique was used associating Heller's esophagocardiomyotomy to an antireflux surgical mechanism (Dor's or Toupet's) in all cases. Intra- and postoperative complications, as well as the postoperative outcome, were evaluated. Results: Ten laparoscopic Heller's esophagocardiomyotomies were performed in 5 girls and 5 boys with achalasia. Age ranged between 2 and 13 years. Mean operating time was 120 minutes. Hospital stay ranged between 3 and 41 days. Complications were recorded in 3 patients: in 2 an esophageal mucosal perforation and in 1 a prolonged dysphagia. Two of these complications occurred in the last patients operated on. Follow-up varied from 6 months to 6 years. All children were free of symptoms. Conclusions: The results show that laparoscopic Heller's esophagocardiomyotomy in children is a feasible procedure. Assessment of mucosal integrity immediately after the myotomy must be performed. Complications can happen even if the operation is performed by expert laparoscopic surgeons. J Pediatr Surg 35:680-683. Copyright © 2000 by W.B. Saunders Company.