[Heller laparoscopic cardiomyotomy with Douro fundoplication - a standard for the treatment of cardiac achalasia in children].

Autor:	Razumovsky AY; Pirogov Russian National Research Medical University, Moscow, Russia.; Filatov Children's Clinical Hospital No. 13, Moscow, Russia., Alkhasov AB; National Medical Research Center for Children's Health, Moscow, Russia., Mitupov ZB; Pirogov Russian National Research Medical University, Moscow, Russia.; Filatov Children's Clinical Hospital No. 13, Moscow, Russia., Savelyeva MS; National Medical Research Center for Children's Health, Moscow, Russia., Chubko DM; Krasnoyarsk Regional Clinical Center for Maternity and Childhood Protection, Krasnoyarsk, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2021 (9), pp. 48-53.
DOI:	10.17116/hirurgia202109148
Abstrakt:	Objective: To analyze 20-year experience in surgical treatment of cardiac achalasia. Material and Methods: A retrospective analysis included 35 children (20 boys and 15 girls) who underwent surgical treatment of cardiac achalasia at the Filatov Children's Clinical Hospital No. 13 for the period 2001-2020. Results: Heller laparoscopic cardiomyotomy with Douro fundoplication was followed by favorable outcomes in 33 (94.3%) children. We also observed significant decrease of postoperative Eckardt score compared to baseline values. Conclusion: Methods of cardiodilation (balloon dilatation, bougienage) ensure a short-term effect and may be only used in addition to surgical treatment. Heller laparoscopic cardiomyotomy with Douro fundoplication results favorable outcome in more than 92% of patients and can be considered as a standard for the treatment of this disease in children. Oral endoscopic myotomy cannot be considered as an alternative to Heller laparoscopic cardiomyotomy with Douro fundoplication due to high risk of secondary gastroesophageal reflux and its complications. Therefore, additional fundoplication is required that makes treatment of cardiac achalasia more invasive and expensive compared to Heller laparoscopic cardiomyotomy with Douro fundoplication.
Databáze:	MEDLINE
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