High-resolution manometric guidance during laparoscopic Heller myotomy: Impact on quality of life and symptom severity for children with achalasia
| Autor: | Eric H. Rosenfeld, Yangyang R. Yu, Mary L. Brandt, Sara C. Fallon, Eric H. Chiou, Bruno P. Chumpitazi |
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| Rok vydání: | 2019 |
| Předmět: |
Myotomy
medicine.medical_specialty Adolescent Manometry medicine.medical_treatment Achalasia High resolution Heller Myotomy 03 medical and health sciences 0302 clinical medicine Quality of life 030225 pediatrics otorhinolaryngologic diseases medicine Humans Child Retrospective Studies business.industry Symptom severity General Medicine medicine.disease Esophageal Achalasia 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health GERD Physical therapy Gastroesophageal Reflux Quality of Life Surgery Laparoscopy Survey instrument business Laparoscopic Heller Myotomy |
| Zdroj: | Journal of pediatric surgery. 54(5) |
| ISSN: | 1531-5037 |
| Popis: | Background High-resolution esophageal manometry (HREM) during laparoscopic Heller myotomy (LHM) with fundoplication for achalasia allows tailoring of myotomy length and wrap tightness. The purpose of this study is to quantify long-term postoperative symptom severity and quality of life using validated questionnaires. Methods Children ≤ 18 years with achalasia who previously underwent LHM with intraoperative HREM from 2010 to 2017 were prospectively surveyed. Eckardt Symptom Score (ESS), Achalasia Severity Questionnaire (ASQ), Pediatric Quality of Life Inventory (PedsQL), and Pediatric GERD Symptom and Quality of Life (PGSQ) questionnaires were administered. Scores for historical controls were obtained from prior survey instrument validation studies as comparison. Results Of 30 eligible patients, 12 (40%) completed the surveys. Mean age at time of surgery was 13 ± 3 years. Assessment was performed at least 10 months after surgery with mean time elapsed of 3.6 ± 2 years. Average premyotomy lower esophageal sphincter (LES) pressure, postmyotomy LES pressure, and postfundoplication LES pressure were 30 ± 10 mmHg, 14 ± 6 mmHg, and 18 ± 9, respectively. ESS (2.3/12), ASQ (39/100 ± 16), PGSQ (symptom: 0.6/4 ± 0.4, school: 0.4/4 ± 0.4), and overall PedsQL (82/100 ± 15) were similar to those of healthy historical controls. Conclusion Children with achalasia undergoing LHM with intraoperative HREM had sustained long-term symptom improvement and quality of life scores comparable to healthy patients. Study and level of evidence Retrospective, II. |
| Databáze: | OpenAIRE |
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