Results of the laparoscopic Heller-Dor procedure for pediatric esophageal achalasia.
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 degrees 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.
Mattioli
G
G
Pediatric Surgery, Gaslini Research Institute, University of Genova, Largo G. Gaslini, 5, 16100 Genova, Italy. girolamomattioli@ospedale-gaslini.ge.it
Esposito
C
C
Pini Prato
A
A
Doldo
P
P
Castagnetti
M
M
Barabino
A
A
Gandullia
P
P
Staiano
A M
AM
Settimi
A
A
Cucchiara
S
S
Montobbio
G
G
Jasonni
V
V
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004931:Esophageal Achalasia / Q000175:diagnosis / Q000601:surgery*; D004939:Esophageal Perforation / Q000209:etiology; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D016896:Treatment Outcome