Thoracoscopic management of non-type C esophageal atresia and tracheoesophageal atresia

Journal of Pediatric Surgery
Steven S Rothenberg

Abstract

This study evaluates the results of thoracoscopic management of complex, non-type C, EA and TEF in infants. From March 2000 to February 2017, 23 patients were treated for Type A N=13, Type B N=4, and Type E N=6. Patients diagnosed with EA had G-tube feeds for a period of 4-9weeks. All procedures were performed thoracoscopically. EA gaps were between 4 and 7 1/2 vertebral bodies. All surgeries were completed thoracoscopically. Average operative time was 95min for Type A, 115min for Type B, and 50min for Type E. Two patients with long gaps had small leaks which resolved with conservative management. One patient with an H-type was re-intubated causing a partial disruption of the tracheal repair. This required thoracoscopic re-exploration with repair and placement of an intercostal muscle flap. No patient has any clinical evidence of fused ribs, chest wall asymmetry, shoulder girdle weakness, or winged scapula. Thoracoscopic repair of complex EA and TEF is safe and effective. The excellent visualization of the thoracic inlet allows for extensive mobilization creating sufficient length for long gaps and safely managing high fistulas. This may limit injury to adjacent structures and avoid a neck incision and chest wall deformity. IV.

Citations

Jun 4, 2019·BMJ Case Reports·Indalecio Cano NovilloMónica De Miguel Moya
Jan 22, 2021·Pediatric Surgery International·Keerthika Sampat, Paul D Losty
Jun 27, 2021·Seminars in Pediatric Surgery·Rocío S GutierrezPatricio Varela Balbontin
Sep 26, 2020·Journal of Pediatric Surgery·Krystian ToczewskiDariusz Patkowski

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