Thoracoscopic repair of esophageal atresia and tracheoesophageal fistula: a multi-institutional analysis.

摘要: Objectives: For the past 60 years, successful repair of esophageal atresia (EA) and distal tracheoesophageal fistula (TEF) has been performed via a thoracotomy. However, number reports have described adverse musculoskeletal sequelae following thoracotomy in infants young children. Until now, only few scattered case detailed an individual surgeon's success with thoracoscopic EA/TEF. This multi-institutional review represents largest experience describing results this approach. Methods: A cohort international pediatric surgeons from centers that perform advanced laparoscopic operations children retrospectively reviewed their data on primary 104 newborns Newborns EA without TEF or those isolated were excluded. Results: In these patients, mean age at operation was 1.2 days (±1.1), weight 2.6 kg (±0.5), operative time 129.9 minutes (±55.5), mechanical ventilation 3.6 (±5.8), total hospitalization 18.1 (±18.6). Twelve (11.5%) developed early leak stricture anastomosis 33 (31.7%) required dilatation least once. Five (4.8%) converted to open one staged due long gap between 2 segments. Twenty-five (24.0%) later fundoplication. recurrent esophagus trachea (1.9%). other including imperforate anus 10 patients (7 high, 3 low), aortopexy (7), duodenal (4), various major cardiac (5). Three died, related EA/TEF 20th postoperative day. Conclusions: The natural evolution correction complicated congenital anomaly can be safely by experienced endoscopic surgeons. presented are comparable previous babies undergoing through Based associated problems thoracotomy, there will likely long-term benefits for repair.