AUTHOR=Peng Dongzi , Tan Yuyong , Li Chenjie , Lv Liang , Zhu Hongyi , Liang Chengbai , Li Rong , Liu Deliang 

TITLE=Peroral Endoscopic Myotomy for Pediatric Achalasia: A Retrospective Analysis of 21 Cases With a Minimum Follow-Up of 5 Years

JOURNAL=Frontiers in Pediatrics

VOLUME=Volume 10 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.845103

DOI=10.3389/fped.2022.845103

ISSN=2296-2360

ABSTRACT=Background: Peroral endoscopic myotomy (POEM) has shown promising short-term safety and efficacy in pediatric patients, while long-term outcomes are largely unknown. This study aimed to assess the clinical effects of POEM for pediatric achalasia who had a follow-up of at least five years.
Methods: Pediatric patients from a single center who underwent a POEM between October 2011and November 2016 were respectively collected and analyzed for long-term clinical outcomes. Patients were contacted to evaluate current symptoms and encouraged repeat endoscopy and manometry. Clinical success, procedure-related parameters, adverse events, gastroesophageal reflux disease after POEM and quality of life were evaluated.
Results: Twenty-four patients who underwent POEM in our center were studied, with a mean age of 14.42±2.65. Two of the 24 patients (8.3%) had previous treatment. The mean of the procedure time was 58.67±19.10 min, 8.3%(2/24) of patients experienced perioperative adverse events. The current symptom scores were obtained from twenty-one patients at a mean follow-up of 92.57 months, the remainder were lost to follow up after a mean of 38 months. Eckardt scores were significantly improved from preoperative baseline (preoperative 7.67±1.62 vs. current 0.86±1.28, P<0.001). Long-term overall success was achieved in 95.8% of patients and none required retreatment for symptoms. 12.5% of patients were suffered from clinical reflux. 76.2% of patients expressed satisfaction with POEM. No severe adverse events were observed during the operation and the 5-years follow-up.
Conclusions: POEM resulted in successful symptomatic mitigation in a majority of pediatric patients after five years. A multi-center large-scale, prospective study is necessary for a confirmed conclusion.