Achalasia

Achalasia is an esophageal motility disorder characterized by the absence of esophageal peristalsis, high resting pressure of the lower esophageal sphincter (LES), and failure of receptive relaxation of the LES. Pharmacological treatments in children including calcium channel blockers (Nifedipine) and intra-sphincteric injection of botulinum toxin have only short-term clinical response. Laparoscopic Heller myotomy with partial fundoplication has been shown to be safe and effective as the definitive management of pediatric achalasia. Since the first pediatric report of peroral endoscopic myotomy (POEM) in 2012, increasing studies have found POEM to be a satisfactory alternative treatment. Comparative studies of the two surgical procedures in children are warranted.