Minimally invasive Heller's myotomy in children: safe and effective.
OBJECTIVE
The aim of the study was to review a single institution experience of minimally invasive Heller's myotomy in pediatric patients with achalasia.


METHODS
An institutional review board-approved retrospective review from 1999 to 2005 identified patients 18 years old and younger who underwent a minimally invasive Heller's myotomy for achalasia.


RESULTS
Twenty-six patients were identified with a mean age of 15 (range, 4-18 years). There were 11 female and 15 male patients. There were 3 intraoperative complications (2 esophageal mucosal injuries and 1 aspiration). There was no mortality. All 26 surgeries were completed laparoscopically. Two patients had Dor fundoplication, whereas 23 patients had Toupet fundoplication. Average length of hospital stay was 2.7 days (range, 1-4 days) excluding the 3 patients with intraoperative complications and 3.5 days for all patients (range, 1-17 days). Postoperative follow-up ranged from 0 to 75 months (mean, 20 months). Postoperatively, one patient developed reflux symptoms (incidence 4%). Seven patients (27%) had recurrence of symptoms at a mean of 13 months (range, 1-66 months) after their operation.


CONCLUSIONS
Laparoscopic Heller's myotomy with fundoplication is a safe and effective treatment of symptomatic achalasia in the pediatric population. Complications were low in this group of patients and comparable to other published reports in the literature.
Department of Surgery, Division of Pediatric Surgery, Mayo Clinic, Rochester, Minn 55905, USA.
Johanna R
JR
Askegard-Giesmann
Jayleen M
JM
Grams
Angela M
AM
Hanna
Corey W
CW
Iqbal
Swee
S
Teh
Christopher R
CR
Moir
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004931:Esophageal Achalasia / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000517:prevention & control / Q000601:surgery; D006801:Humans; D007431:Intraoperative Complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome