{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T10:25:08Z","timestamp":1781346308016,"version":"3.54.1"},"reference-count":0,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003There are no evidence-based guidelines on the surgical management of esophageal achalasia (OA) in children. This can be a challenging condition with significant physical and psychological morbidity. Our aim was to identify the most common management modalities and their outcomes.<\/jats:p><jats:p>\n          Materials and Methods\u2003A systematic review was performed through a literature search of health care databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, aiming at identifying pediatric series discussing the diagnosis and management of OA. Duplicates, case series with\u2009&lt;\u20099 patients, and follow-up of\u2009&lt;\u20091 year were excluded. The included papers were analyzed for diagnostic methods, primary treatment method, complications, follow-up duration, outcome measures recorded, and outcome.<\/jats:p><jats:p>\n          Results\u2003Data from 33 papers for 742 children treated for OA was analyzed. Eleven mentioned multiple management modalities. In summary, 25 described Heller's esophagomyotomy (HM), 13 esophageal dilatation (EOD), and 6 peroral esophageal myotomy (POEM). Mean follow-up was 43.7 months (12\u2013180). Outcome measures were heterogeneous. However, analysis of reported success showed a mean success of 78% for HM (p\u2009=\u20091.79\u2009\u00d7\u200910\u20137), 44.9% for EOD (p\u2009=\u20090.24), and 99.3% for POEM (p\u2009=\u20090.001). Reported complications were 12.8% for HM, 5% for EOD, and 24.4% for POEM. Further interventions were required for 10.9% of HM, 62.3% of EOD, and 0.01% of POEM patient groups.<\/jats:p><jats:p>\n          Conclusion\u2003Methods of diagnosis and measures of successful outcomes were heterogeneous, limiting the strength of evidence. HM showed superior short-term success rates to EOD. POEM is a promising modality but requires investment in equipment and training. Information about sustainability of response and long-term outcomes is lacking.<\/jats:p>","DOI":"10.1055\/s-0039-1697958","type":"journal-article","created":{"date-parts":[[2019,10,10]],"date-time":"2019-10-10T23:06:46Z","timestamp":1570748806000},"page":"013-020","source":"Crossref","is-referenced-by-count":28,"title":["Surgical Management of Esophageal Achalasia in Pediatrics: A Systematic Review"],"prefix":"10.1055","volume":"30","author":[{"given":"Ayman","family":"Goneidy","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Royal Manchester Children's Hospital, Manchester, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Cory-Wright","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Limeng","family":"Zhu","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina","family":"Malakounides","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,10,10]]},"container-title":["European Journal of Pediatric Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0039-1697958.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,2,18]],"date-time":"2020-02-18T23:40:09Z","timestamp":1582069209000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0039-1697958"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,10]]},"references-count":0,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2020,2,18]]},"published-print":{"date-parts":[[2020,2]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0039-1697958","relation":{},"ISSN":["0939-7248","1439-359X"],"issn-type":[{"value":"0939-7248","type":"print"},{"value":"1439-359X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,10]]}}}