Multicenter Evaluation with Eckardt Score of Laparoscopic Management with Heller Myotomy and Dor Fundoplication for Esophageal Achalasia in a Pediatric Population in Colombia

Background: Esophageal achalasia is a rare, chronic, and progressive neurodegenerative motility disorder that is characterized by a lack of relaxation of the lower esophageal sphincter. Laparoscopic Heller myotomy (LHM) is the ideal in our population. Multiple surgical and medical treatments have be...

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Autores:
Chams Anturi, Abraham
Romero Espitia, Walter
Loockhartt, Angelo
Moreno Villamizar, María Daniela
Pedraza Ciro, Mauricio
Villamizar, Joaquín Enrique
Cabrera, Luis Felipe
Tinoco Guzman, Nestor Julian
Beltrán, Jorge
Fierro, Fernando
Holguin, Alejandra
Aragón, Silvia
Giraldo, Carolina
Rodriguez, Maria
Tipo de recurso:
https://purl.org/coar/resource_type/c_6501
Fecha de publicación:
2021
Institución:
Universidad El Bosque
Repositorio:
Repositorio U. El Bosque
Idioma:
spa
OAI Identifier:
oai:repositorio.unbosque.edu.co:20.500.12495/5571
Acceso en línea:
https://hdl.handle.net/20.500.12495/5571
https://doi.org/10.1089/lap.2020.0055
Palabra clave:
Deglutition disorders
Esophageal achalasia
Esophageal diseaseses
Ophageal motility disorders
Heller myotomy
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Summary:Background: Esophageal achalasia is a rare, chronic, and progressive neurodegenerative motility disorder that is characterized by a lack of relaxation of the lower esophageal sphincter. Laparoscopic Heller myotomy (LHM) is the ideal in our population. Multiple surgical and medical treatments have been raised. However, there has been a need to expand studies and generate a clear algorithm for an ideal therapeutic algorithm. Methods: Clinical record was retrospectively analyzed of patients who underwent LHM and Dor fundoplication evaluated with Eckardt score, at four Colombian medical centers between February 2008 and December 2018. Results: There were a total of 21 patients (12 males and 9 females, ages 8 months to 16 years). The time from onset of symptoms to surgery was between 5 months and 14 years. One patient had esophageal mucosa perforation, 2 patients were converted to open surgery, and 1 patient had a postoperative fistula. All patients were discharged 3 to 9 days postoperatively, at which time they tolerated normal oral feeding. During follow-up, all the patients had an improvement in nutritional status and a greater functional recovery; 4 had reflux and 1 had reflux-like symptoms. Conclusion: LHM with Dor-type fundoplication maintains the effectiveness of open surgery with low postoperative morbidity and mortality and good functional results according to Eckardt score evaluation. © Copyright 2021, Mary Ann Liebert, Inc., publishers 2021.