title: Usefulness of peroral endoscopic myotomy for treating achalasia in children: experience from a single center.
abstract: BACKGROUND
  Achalasia is a rare esophageal motility disorder in the pediatric population. Peroral endoscopic myotomy (POEM) has been demonstrated to be effective and safe for the treatment of achalasia as a novel endoscopic technique, but data involving its utility in pediatric patients are limited. We aimed to assess the safety and efficacy of POEM for pediatric patients with achalasia.
  
  
  METHODS
  Between July 2012 and August 2014, five consecutive pediatric patients (2 female and 3 male, with a median age of 15 years) with achalasia underwent POEM in our center. Diagnosis was based on symptoms, manometry, radiology and endoscopy. Preoperative and postoperative symptoms scores, and manometry outcomes were recorded and analyzed.
  
  
  RESULTS
  Procedure was performed successfully in all patients, and the median time required for the procedure was 50 min (range 40-90 min). There were no mortalities and no serious intraoperative and postoperative complications. The median length of myotomy was 8 cm (range 6-11 cm). During a median follow-up period of 18 months, treatment success (Eckardt score ≤3) was achieved in all patients. There was a significant improvement of symptoms relief, dysphagia score and lower esophageal sphincter pressure decrease after POEM. No patient developed gastroesophageal reflux disease.
  
  
  CONCLUSIONS
  Our study suggests that POEM is a safe and effective technique for treating pediatric achalasia. Further studies with long-term follow-up in large-volume pediatric patients are warranted to clearly define the durability of the procedure.
authors.affiliation: Department of Gastroenterology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou North Ave, Guangzhou, 510515, China.
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Tang
authors.forename: Wei
authors.initials: W
authors.lastname: Gong
authors.forename: Zhiliang
authors.initials: Z
authors.lastname: Deng
authors.forename: Jieqiong
authors.initials: J
authors.lastname: Zhou
authors.forename: Yutang
authors.initials: Y
authors.lastname: Ren
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.forename: Zhenyu
authors.initials: Z
authors.lastname: Chen
authors.forename: Bo
authors.initials: B
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D004931:Esophageal Achalasia / Q000601:surgery*; D004945:Esophagoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome