{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T04:01:49Z","timestamp":1768968109183,"version":"3.49.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T00:00:00Z","timestamp":1768867200000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100019256","name":"NIHR GOSH BRC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100019256","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Achalasia is rare disease in children and young people (CYP) that causes significant symptoms and often requires invasive interventions. There is currently no consensus on the optimal management strategy. This study investigated the current management and outcomes of CYP with achalasia in the UK.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted of CYP (aged \u2264 16 years) diagnosed with achalasia between 2011 and 2021 in the UK. The study was co-designed with the patient group Achalasia Action. Data were collected from patient records. The primary outcome was treatment success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In all, 126 patients were included from 13 UK centres; 64 of the patients (50.8%) were male and the median age at diagnosis was 12 (interquartile range (i.q.r.) 9\u201314) years. The most frequent presenting features were dysphagia (73.8%), vomiting (53.2%), and weight loss (38.9%). The median time from symptom onset to diagnosis was 11 (i.q.r. 6\u201324) months. Treatment success was achieved in 55 of 120 patients (45.8%) after first-line intervention. Heller\u2019s cardiomyotomy (HCM) as the first-line intervention had a higher success rate than endoscopic balloon dilatation (EBD; (52 of 72 (72%) versus 3 of 48 (6%), respectively; P &amp;lt; 0.001). However, overall HCM had a higher frequency of complications than EBD (17 of 98 (17%) versus 3 of 57 (5%), respectively; P = 0.045). In the entire cohort, 53% of patients reported symptoms at the 1-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Variation exists in the management of CYP with achalasia in the UK. The highest rates of treatment success were associated with HCM. Many CYP remain symptomatic after treatment and require multiple interventions. The present data can be used to inform management decisions in CYP with achalasia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zraf139","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T11:40:00Z","timestamp":1759837200000},"source":"Crossref","is-referenced-by-count":0,"title":["Management and outcomes of paediatric achalasia: multicentre retrospective study in the UK"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4049-3896","authenticated-orcid":false,"given":"Jonathan J","family":"Neville","sequence":"first","affiliation":[{"name":"Great Ormond Street Institute of Child Health, University College London , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Westwood","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Evelina Children\u2019s Hospital , London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Ladell","sequence":"additional","affiliation":[{"name":"Achalasia Action, London ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George S","family":"Bethell","sequence":"additional","affiliation":[{"name":"University Surgery Unit, University of Southampton , Southampton ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3440-3142","authenticated-orcid":false,"given":"Rachel","family":"Harwood","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Alder Hey Children\u2019s Hospital , Liverpool ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8570-9374","authenticated-orcid":false,"given":"Nigel J","family":"Hall","sequence":"additional","affiliation":[{"name":"University Surgery Unit, University of Southampton , Southampton ,","place":["UK"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"the PSTRN Collaborators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamad E","family":"Abdullah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Charlesworth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liza Y W","family":"Chong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"Clark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Colvin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahish","family":"Desai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hany","family":"Gabra","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Giuliani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucinda","family":"Tullie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dale","family":"Gracie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naotunna Palliyage Nuwanthika","family":"Karunaratne","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saravanakumar","family":"Paramalingam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Pelosi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shazia","family":"Perveen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amulya","family":"Saxena","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giampiero","family":"Soccorso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe","family":"Roy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iain","family":"Yardley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan","family":"Wills","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel Tan Wei","family":"Ying","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"key":"2026012010332897600_zraf139-B1","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1053\/j.sempedsurg.2017.02.001","article-title":"Achalasia","volume":"26","author":"Islam","year":"2017","journal-title":"Semin Pediatr Surg"},{"key":"2026012010332897600_zraf139-B2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1055\/s-0039-1697958","article-title":"Surgical management of esophageal achalasia in pediatrics: a systematic review","volume":"30","author":"Goneidy","year":"2020","journal-title":"Eur J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jpeds.2015.10.057","article-title":"Pediatric achalasia in the Netherlands: incidence, clinical course, and quality of life","volume":"169","author":"Smits","year":"2016","journal-title":"J Pediatr"},{"key":"2026012010332897600_zraf139-B4","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.jpeds.2022.07.010","article-title":"Comparison of endoscopic dilatation and Heller\u2019s myotomy for treating esophageal achalasia in children: a multicenter study","volume":"251","author":"Nicolas","year":"2022","journal-title":"J Pediatr"},{"key":"2026012010332897600_zraf139-B5","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1007\/s00431-017-2924-x","article-title":"Long-term outcomes of Heller\u2019s myotomy and balloon dilatation in childhood achalasia","volume":"176","author":"Saliakellis","year":"2017","journal-title":"Eur J Pediatr"},{"key":"2026012010332897600_zraf139-B6","doi-asserted-by":"crossref","first-page":"3656","DOI":"10.1007\/s00464-018-06654-1","article-title":"Outcome of peroral endoscopic myotomy in children with achalasia","volume":"33","author":"Nabi","year":"2019","journal-title":"Surg Endosc"},{"key":"2026012010332897600_zraf139-B7","doi-asserted-by":"crossref","first-page":"728","DOI":"10.1016\/j.jpedsurg.2022.02.017","article-title":"Per oral endoscopic myotomy (POEM) for pediatric achalasia: institutional experience and outcomes","volume":"57","author":"Petrosyan","year":"2022","journal-title":"J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B8","doi-asserted-by":"crossref","first-page":"1446","DOI":"10.1111\/jgh.16945","article-title":"Clinical characteristics and long-term efficacy of peroral endoscopic myotomy in pediatric achalasia","volume":"40","author":"Shimamura","year":"2025","journal-title":"J Gastroenterol Hepatol"},{"key":"2026012010332897600_zraf139-B9","first-page":"1","article-title":"Laparoscopic Heller myotomy versus peroral endoscopic myotomy in children with esophageal achalasia: a systematic review and meta-analysis","volume":"37","author":"Dimopoulou","year":"2024","journal-title":"Ann Gastroenterol"},{"key":"2026012010332897600_zraf139-B10","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"2026012010332897600_zraf139-B11","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1002\/jpn3.70128","article-title":"Outcome reporting in studies of paediatric achalasia: a systematic review","volume":"81","author":"Neville","year":"2025","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2026012010332897600_zraf139-B12","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1016\/j.jpedsurg.2023.11.003","article-title":"Robotic-assisted vs. laparoscopic Heller\u2019s myotomy for achalasia in children","volume":"59","author":"Delgado-Miguel","year":"2024","journal-title":"J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B13","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jpedsurg.2020.02.028","article-title":"Treating children with achalasia using per-oral endoscopic myotomy (POEM): twenty-one cases in review","volume":"55","author":"Wood","year":"2020","journal-title":"J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B14","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.jpedsurg.2013.11.042","article-title":"Paediatric laparoscopic Heller\u2019s cardiomyotomy: a single centre series","volume":"49","author":"Pachl","year":"2014","journal-title":"J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B15","doi-asserted-by":"crossref","first-page":"e14058","DOI":"10.1111\/nmo.14058","article-title":"Esophageal motility disorders on high-resolution manometry: Chicago classification version 4.0\u00a9","volume":"33","author":"Yadlapati","year":"2021","journal-title":"Neurogastroenterol Motil"},{"key":"2026012010332897600_zraf139-B16","author":"Growth Charts - CDC growth charts","year":"2025"},{"key":"2026012010332897600_zraf139-B17","doi-asserted-by":"crossref","first-page":"3602","DOI":"10.1007\/s00464-024-10884-x","article-title":"Complications after Heller myotomy in children: a national multicenter study on the impact of prior endoscopic dilatation and identification of risk factors","volume":"38","author":"Montalva","year":"2024","journal-title":"Surg Endosc"},{"key":"2026012010332897600_zraf139-B18","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1002\/bjs.11049","article-title":"Meta-analysis of clinical outcome after treatment for achalasia based on manometric subtypes","volume":"106","author":"Andolfi","year":"2019","journal-title":"Br J Surg"},{"key":"2026012010332897600_zraf139-B19","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1136\/gutjnl-2015-310602","article-title":"Long-term results of the European achalasia trial: a multicentre randomised controlled trial comparing pneumatic dilation versus laparoscopic Heller myotomy","volume":"65","author":"Moonen","year":"2016","journal-title":"Gut"},{"key":"2026012010332897600_zraf139-B20","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1089\/lap.2016.0169","article-title":"Results of laparoscopic Heller\u2019s myotomy for achalasia in children: a systematic review of the literature","volume":"27","author":"Pacilli","year":"2017","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"2026012010332897600_zraf139-B21","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1055\/s-0043-1760822","article-title":"Laparoscopic Heller\u2013Dor is a persistently effective treatment for achalasia even in pediatric patients: a 25-year experience at a single tertiary center","volume":"33","author":"Provenzano","year":"2023","journal-title":"Eur J Pediatr Surg"},{"key":"2026012010332897600_zraf139-B22","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1056\/NEJMoa1010502","article-title":"Pneumatic dilation versus laparoscopic Heller\u2019s myotomy for idiopathic achalasia","volume":"364","author":"Boeckxstaens","year":"2011","journal-title":"N Engl J Med"},{"key":"2026012010332897600_zraf139-B23","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1136\/gut.2010.211409","article-title":"Predictors for outcome of failure of balloon dilatation in patients with achalasia","volume":"60","author":"Alderliesten","year":"2011","journal-title":"Gut"},{"key":"2026012010332897600_zraf139-B24","first-page":"CD013386","article-title":"Fundoplication in laparoscopic Heller\u2019s cardiomyotomy for achalasia","volume":"12","author":"Midya","year":"2022","journal-title":"Cochrane Database Syst Rev"},{"key":"2026012010332897600_zraf139-B25","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1001\/jama.2019.8859","article-title":"Effect of peroral endoscopic myotomy vs pneumatic dilation on symptom severity and treatment outcomes among treatment-naive patients with achalasia: a randomized clinical trial","volume":"322","author":"Ponds","year":"2019","journal-title":"JAMA"},{"key":"2026012010332897600_zraf139-B26","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1080\/17474124.2018.1441023","article-title":"Clinical management of pediatric achalasia","volume":"12","author":"van Lennep","year":"2018","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"2026012010332897600_zraf139-B27","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S2468-1253(25)00012-3","article-title":"Per-oral endoscopic myotomy versus laparoscopic Heller\u2019s myotomy plus Dor fundoplication in patients with idiopathic achalasia: 5-year follow-up of a multicentre, randomised, open-label, non-inferiority trial","volume":"10","author":"Hugova","year":"2025","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2026012010332897600_zraf139-B28","doi-asserted-by":"crossref","first-page":"e38970","DOI":"10.1097\/MD.0000000000038970","article-title":"Efficacy and safety of peroral endoscopic myotomy for pediatric achalasia: a nationwide study","volume":"103","author":"Luvsandagva","year":"2024","journal-title":"Medicine (Baltimore)"},{"key":"2026012010332897600_zraf139-B29","doi-asserted-by":"crossref","first-page":"e0286880","DOI":"10.1371\/journal.pone.0286880","article-title":"Protocol for an international multicenter randomized controlled trial assessing treatment success and safety of peroral endoscopic myotomy vs endoscopic balloon dilation for the treatment of achalasia in children","volume":"18","author":"Mussies","year":"2023","journal-title":"PLoS One"},{"key":"2026012010332897600_zraf139-B30","doi-asserted-by":"crossref","first-page":"e003130","DOI":"10.1136\/bmjpo-2024-003130","article-title":"Development of a core outcome set for paediatric achalasia: a joint ERNICA, ESPGHAN and EUPSA study protocol","volume":"9","author":"Neville","year":"2025","journal-title":"BMJ Paediatr Open"}],"container-title":["BJS Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/10\/1\/zraf139\/66475974\/zraf139.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjsopen\/article-pdf\/10\/1\/zraf139\/66475974\/zraf139.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T15:33:36Z","timestamp":1768923216000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjsopen\/article\/doi\/10.1093\/bjsopen\/zraf139\/8431530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,29]]},"references-count":30,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,12,29]]}},"URL":"https:\/\/doi.org\/10.1093\/bjsopen\/zraf139","relation":{},"ISSN":["2474-9842"],"issn-type":[{"value":"2474-9842","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,2]]},"published":{"date-parts":[[2025,12,29]]},"article-number":"zraf139"}}