Acalasia esofagea in età pediatrica: descrizione di due casi clinici trattati con tecnica videolaparoscopica

ACHALASIA IN PAEDIATRIC AGE: TWO CASES REPORT TREATED WITH MINIMALLY INVASIVE SURGERY: the Authors provide a study about 2 cases with achalasia treated with laparoscopic Heller myotomy and anterior fundoplication according to Thall, at the University of Siena. The preoperative exams included clinical examination, a barium x-ray of the upper digestive tract and a esophageal-gastric-scopy. One patient had a Rett's syndrome. Postoperatively, the patients showed a normal weight curve and complete resolution of symptoms. Ali patients showed complete regression of digestive and respiratory symptoms from the very first examination, with a normal oral meal intake and an improvement of weight and height parameters, In conclusion, the Authors suggest that modified extramucosal Heller cardiomyotomy associated to 180° anterior antireflux plastic surgery (according to both Thal and Dor 's procedures) is a usefull and safe procedure in the treatment of oesophageal achalasia in paediatric patients. Our data - which are supported by a long term follow up - also stress the relevance of the anterior fundoplication in preventing postoperative gastroesophageal reflux.