Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome.

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.

journal_name

Pediatr Surg Int

authors

Shirota C,Tanaka Y,Tainaka T,Sumida W,Yokota K,Makita S,Oshima K,Tanaka T,Tani Y,Uchida H

doi

10.1007/s00383-019-04541-x

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

1071-1076

issue

10

eissn

0179-0358

issn

1437-9813

pii

10.1007/s00383-019-04541-x

journal_volume

35

pub_type

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