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09.08.2019 | Original Article

Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome

verfasst von: Chiyoe Shirota, Yujiro Tanaka, Takahisa Tainaka, Wataru Sumida, Kazuki Yokota, Satoshi Makita, Kazuo Oshima, Tomoko Tanaka, Yukiko Tani, Hiroo Uchida

Erschienen in: Pediatric Surgery International | Ausgabe 10/2019

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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.

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Titel: Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome
verfasst von: Chiyoe Shirota
Yujiro Tanaka
Takahisa Tainaka
Wataru Sumida
Kazuki Yokota
Satoshi Makita
Kazuo Oshima
Tomoko Tanaka
Yukiko Tani
Hiroo Uchida
Publikationsdatum: 09.08.2019
Verlag: Springer Berlin Heidelberg
Erschienen in: Pediatric Surgery International / Ausgabe 10/2019
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI: https://doi.org/10.1007/s00383-019-04541-x

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Therapeutic strategy for thoracoscopic repair of esophageal atresia and its outcome