Thoracoscopic repair of esophageal atresia and tracheoesophageal fistula: lessons learned

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Thang NguyenNam Nguyen

Abstract

Repair of esophageal atresia and tracheoesophageal fistula has traditionally been performed via thoracotomy. This study aims to evaluate the feasibility and pitfalls of the thoracoscopic approach. Six consecutive patients with type C tracheoesophageal fistulae underwent thoracoscopic repair. The operation was approached through the right chest using a three-trocar technique (two 5-mm and one 3-mm) with the patient placed in a three-quarter prone position. Patient characteristics, operative time, duration of narcotic usage, conversion factors, postoperative complications, and long-term follow-up were recorded. Five of six patients were successfully operated on thoracoscopically. The average operative time was 143 minutes (range, 75-215 minutes) with repair of long-gap defects requiring significantly longer times than short-gap defects (200 vs. 129 minutes, P < 0.05). There were no intraoperative complications. Mean duration of narcotic use was 52 hours (range, 24-72 hours). There were no anastomotic leaks. One patient developed an anastomotic stricture at the third postoperative week, which resolved with two dilations. One patient died on the first postoperative day from respiratory failure. Thoracoscopic repair of esophageal at...Continue Reading

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Citations

Feb 26, 2010·Pediatric Surgery International·Akihiro ShimotakaharaAtsuyuki Yamataka
Nov 4, 2008·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Dariusz PatkowskJerzy Czernik
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