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Surgery in Motility Disorders

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Pediatric Neurogastroenterology

Abstract

Gastrointestinal motility disorders pose a major clinical challenge because of the limitations of diagnostic tests and the lack of efficacious therapeutic options. Gastrointestinal motility disorders comprise heterogeneous conditions that may affect any area of the digestive tract resulting from abnormality of enteric neuromuscular function. Motility disorders are frequently chronic and may markedly affect patients’ quality of life. Despite significant progress has been made over the last years, the exact nature and pathophysiological mechanisms of most gastrointestinal motility disorders remain largely unknown. Unfortunately, most dysmotility disorders cannot be cured and treatment are only offered to relieve symptoms, reduce morbidity and mortality, and improve quality of life. Surgery has a pivotal role in managing patients with motility disorders representing the treatment of choice in different conditions or an important intervention to be associated with medical therapies.

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Abbreviations

CC:

Chicago classification

DES:

Diffuse esophageal spasm

EA:

Esophageal atresia

EGJ:

Esophagogastric junction

ERAS:

Enhanced recovery after surgery

ESPGHAN:

European Society for Pediatric Gastroenterology, Hepatology, and Nutrition

FI:

Faecal incontinence

GER:

Gastroesophageal reflux

GERD:

Gastroesophageal reflux disease

HAEC:

Hirschsprung-associated enterocolitis

HD:

Hirschsprung’s disease

HRM:

High-resolution manometry

IAS:

Internal anal sphincter

IFALD:

Intestinal failure associated liver disease

JH:

Jackhammer esophagus

LES:

Lower esophageal sphincter

LHM:

Laparoscopic Heller’s myotomy

MEN2A:

Multiple Endocrine Neoplasia type 2A

NASPGHAN:

North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition

NI:

Neurological impairment

PEG:

Percutaneous endoscopic gastrostomy

PEG-J:

Percutaneous endoscopic gastro-jejunostomy

PIPO:

Pediatric intestinal pseudo-obstruction

PN:

Parenteral nutrition

POEM:

Peroral endoscopic myotomy

PPI:

Proton pump inhibitor

RAIR:

Recto-anal inhibitory reflex

TCA:

Total colonic aganglionosis

TLESR:

Transient Lower esophageal sphincter relaxation

TPN:

Total parenteral nutrition

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De Angelis, P. et al. (2022). Surgery in Motility Disorders. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-031-15229-0_50

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