Results of the laparoscopic Heller-Dor procedure for pediatric esophageal achalasia

Background: Esophageal achalasia is not a frequent disorder in children and different treatments have been proposed during past decades. This study reviews the results of the laparoscopic Heller-Dor procedure performed in pediatric patients in two different surgical units. Methods: We included the patients aged <14 years with a minimum follow-up of 6 months operated on in the period 1994–2001. A single longitudinal anterior esophageal myotomy (Heller) and a 180 anterior gastropexy (Dor) were laparoscopically performed. The patients were checked to detect intra- or postoperative complications and recurrence. Results: Twenty children were operated on. Mean follow- up was 45 months (range 6–102). Postoperative clinical score was Visick 1 in 15 cases and Visick 2 in five. Conclusions: As complication and recurrence rates are very low we consider modified Heller myotomy and Dor gastropexy through a laparoscopic approach our first choice to treat esophageal achalasia in the pediatric population.