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Purpose <p>Thoracoscopic repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) is a technically demanding operation. We hypothesize thoracoscopic repair of EA with TEF over time has increased, with improved or equivalent outcomes compared to open.</p> Methods <p>NSQIP-P identified patients &lt; 30 days with EA and TEF who underwent repair of both defects from 2016 to 2022. Patients were categorized into (1) intention to treat (thoracoscopic/thoracoscopic converted to open); and (2) thoracoscopic only, both compared to open only patients. Coarsened exact matching was performed. Pre/post-match analysis utilized <i>X</i><sup>2</sup>, Fisher’s exact, and Mann-Whitney-U tests.</p> Results <p>Overall, 1,188 patients were identified with 147 (12.4%) thoracoscopic only, 129 (10.8%) converted to open, and 912 (76.8%) open only. Thoracoscopic repair increased (2016–2022) for intention to treat (12.0% vs. 29.4%, <i>p</i> = 0.001) and thoracoscopic only (7.2% vs. 19.1%, <i>p</i> = 0.012) cohorts. Matched analysis identified thoracoscopic patients had reduced length of stay (<i>p</i> = 0.005) and longer operative time (&lt; 0.01); however, no difference in other outcomes were identified (<i>p</i> &gt; 0.05).</p> Conclusion <p>Thoracoscopic repair of EA with TEF attempts have increased to roughly 30%, and it is associated with reduced length of stay and longer operative times without other outcome differences. This analysis affirms the short-term safety of thoracoscopic repair of EA and TEF.</p> Level of evidence (I-V) <p>Level III.</p>

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Trends and outcomes of thoracoscopic esophageal atresia and tracheoesophageal fistula repair: a retrospective analysis 2016–2022

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月15日

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  • John M. Woodward,
  • Patricia Corujo Avila,
  • Aaron Orellana,
  • Kaity Tung,
  • Melanie Tacher Otero,
  • Lindsey Caines,
  • Krystle Bittner,
  • Anshul Kumar,
  • Carroll M. Harmon,
  • P. Benson Ham III

摘要

Purpose

Thoracoscopic repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) is a technically demanding operation. We hypothesize thoracoscopic repair of EA with TEF over time has increased, with improved or equivalent outcomes compared to open.

Methods

NSQIP-P identified patients < 30 days with EA and TEF who underwent repair of both defects from 2016 to 2022. Patients were categorized into (1) intention to treat (thoracoscopic/thoracoscopic converted to open); and (2) thoracoscopic only, both compared to open only patients. Coarsened exact matching was performed. Pre/post-match analysis utilized X2, Fisher’s exact, and Mann-Whitney-U tests.

Results

Overall, 1,188 patients were identified with 147 (12.4%) thoracoscopic only, 129 (10.8%) converted to open, and 912 (76.8%) open only. Thoracoscopic repair increased (2016–2022) for intention to treat (12.0% vs. 29.4%, p = 0.001) and thoracoscopic only (7.2% vs. 19.1%, p = 0.012) cohorts. Matched analysis identified thoracoscopic patients had reduced length of stay (p = 0.005) and longer operative time (< 0.01); however, no difference in other outcomes were identified (p > 0.05).

Conclusion

Thoracoscopic repair of EA with TEF attempts have increased to roughly 30%, and it is associated with reduced length of stay and longer operative times without other outcome differences. This analysis affirms the short-term safety of thoracoscopic repair of EA and TEF.

Level of evidence (I-V)

Level III.