Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome
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In brief
In brief
Retrospective study of 38 thoracoscopic esophageal atresia repairs (2013-2018) demonstrates feasibility across most Gross types using single- or multistage approaches. Results show no intraoperative complications, 9% chylothorax rate, and 21% requiring balloon dilation for stenosis, with cervical approach reserved for high proximal pouches.
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Abstract
Purpose
Thoracoscopic repair can be safely performed in most types of congenital esophageal atresia (EA), including in patients with long gap EA or very low birth weight. Accordingly, we performed single- or multistage thoracoscopic repair for various EA types. We aimed to report our therapeutic strategy for thoracoscopic radical surgery for treating EA and its outcome.
Methods
Outcomes of radical surgeries for treating congenital EA at our institute from 2013 to 2018 were retrospectively evaluated.
Results
Thirty-eight radical surgeries were evaluated: 3 Gross type-A, 1 type-B, 30 type-C, 1 type-D, and 3 type-E. The cervical approach was performed in 5 cases and thoracoscopic esophageal anastomosis in 33, including 26 single-stage (all type-C) and 7 multistage surgeries (3 type-A, 3 type-C, and 1 type-D). There were no cases of thoracotomies or intraoperative thoracoscopic surgery complications. Three cases of minor leakage were conservatively resolved. Three postoperative chylothorax surgeries (9%) and seven balloon dilatations (21%) for anastomotic stenosis were performed.
Conclusion
Thoracoscopic radical surgery for treating EA, including single- and multistage procedures, can be performed, except in type-E cases or when the end of the proximal esophagus is located higher than the clavicle.