Thoracoscopic Repair of Esophageal Atresia With Distal Tracheoesophageal Fistula (Type C): Systematic Review.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
Roberta V Iacona, Amulya K Saxena

Abstract

This systematic review analyzed outcomes in thoracoscopic "primary" repair of type-C esophageal atresia. The Healthcare Database Advance Search, Embase, Medline, and Cochrane databases in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were researched by 2 independent reviewers. Non-English, mixed procedures (open/thoracoscopic) and staged-repair articles were excluded. Between 2000 and 2018, 173 articles were identified of which 14 met the inclusion criteria and 382 neonates analyzed. Lowest reported age and weight were 28 gestational weeks and 830 g, respectively (gestational weeks: 28 to 41 wk; birth weight: 830 to 3960 g), with 136/382 (36%) having associated comorbidities. All procedures were performed in Cuschieri modified decubitus position with 3 ports (3.5 to 5 mm) and 30-degree scopes. Azygos vein sparing approach was reported in 4/14 (28.5%) articles; and if divided 70% preferred sealing/diathermy devices. Preferences for fistula ligation were sutures in 5/13 (38%) articles, clips or hemlock in 4/13 (30.7%), sutures with clips in 4/13 (30.7%) and no data in 1/14. Transanastomotic tubes placement was reported in 9/14 articles (others no data). Chest tube placement...Continue Reading

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