High-resolution manometric guidance during laparoscopic Heller myotomy: Impact on quality of life and symptom severity for children with achalasia.
J Pediatr Surg
; 54(5): 1063-1068, 2019 May.
Article
em En
| MEDLINE
| ID: mdl-30808541
ABSTRACT
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 ≤18â¯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⯱â¯3â¯years. Assessment was performed at least 10â¯months after surgery with mean time elapsed of 3.6⯱â¯2â¯years. Average premyotomy lower esophageal sphincter (LES) pressure, postmyotomy LES pressure, and postfundoplication LES pressure were 30⯱â¯10â¯mmHg, 14⯱â¯6â¯mmHg, and 18⯱â¯9, respectively. ESS (2.3/12), ASQ (39/100⯱â¯16), PGSQ (symptom 0.6/4⯱â¯0.4, school 0.4/4⯱â¯0.4), and overall PedsQL (82/100⯱â¯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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Acalasia Esofágica
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Miotomia de Heller
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Manometria
Tipo de estudo:
Diagnostic_studies
/
Guideline
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Observational_studies
/
Risk_factors_studies
Limite:
Adolescent
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Child
/
Humans
Idioma:
En
Revista:
J Pediatr Surg
Ano de publicação:
2019
Tipo de documento:
Article