Thoracoscopic primary repair is useful for esophageal atresia with tracheoesophageal fistula in neonates with low body weight
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In brief
In brief
This study demonstrates that thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula is safe in neonates weighing under 2000g, with comparable outcomes to heavier infants. However, emergency surgery on day 0 carries increased risk of anastomotic leakage and should be approached cautiously.
- Thoracoscopic repair of EA/TEF is safe in neonates <2000g with outcomes comparable to larger infants.
- Emergency surgery on day of life 0 carries higher anastomotic leak risk compared to delayed repair (p=0.02).
- Anastomotic leaks after thoracoscopic EA/TEF repair can be managed conservatively without conversion to open surgery.
- Low birth weight alone should not preclude thoracoscopic approach for EA/TEF repair in experienced centers.
- Delaying surgery beyond day 0 when clinically feasible may reduce anastomotic complications in EA/TEF repair.
Written by the GCMD Library team from the article.
Abstract
Purpose
The surgical indication of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula is under debate. The current study aimed to investigate the outcome of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula in patients weighing < 2000 g and those who underwent emergency surgery at the age of 0 day.
Methods
The surgical outcomes were compared between patients weighing < 2000 g and those weighing > 2000 g at surgery and between patients who underwent surgery at the age of 0 day and those who underwent surgery at age ≥ 1 day.
Results
In total, 43 patients underwent thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula. The surgical outcomes according to body weight were similar. Patients who underwent surgery at the age of 0 day were more likely to develop anastomotic leakage than those who underwent surgery at the age of ≥ 1 day (2 vs. 0 case, p = 0.02). Anastomotic leakage was treated with conservative therapy.
Conclusion
Thoracoscopic primary repair is safe and useful for esophageal atresia with tracheoesophageal fistula even in newborns weighing < 2000 g. However, emergency surgery at the age of 0 day should be cautiously performed due to the risk of anastomotic leakage.