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Purpose <p>The early experience of thoracoscopic esophageal atresia and tracheoesophageal fistula (EA/TEF) repair at a small volume centre.</p> Methods <p>Eleven patients underwent thoracoscopic repair of esophageal atresia between 2018 and 2024. The gestational age ranged from 31 to 40&#xa0;weeks, birth weight was 1360–3280&#xa0;g. All were diagnosed postnatally. In ten cases, esophageal atresia (EA) with distal fistula was identified (Type C) and in one long-gap EA without fistula (Type A). Five newborns had associated malformations. Three ports technique was used, the fistula closure was performed by nonabsorbable suture or titanium clip. Interrupted suture was used for anastomosis and an 8-French chest tube was used.</p> Results <p>Twelve thoracoscopic procedures were performed in total. In the long-gap EA, an internal traction suture was applied at first and anastomosis was performed during the second operation. Conversion was necessary in two cases (loss of needle, endotracheal (ET) cannula dislocation). In one case, a colostomy was performed at the same time due to cloaca. Average operating time was 202 ± 68&#xa0;min (range 120–340&#xa0;min) and improved with gaining experience. The first esophagography was usually on the 8th day. Minimal anastomotic leak was observed in three patients. During 3–75&#xa0;months of follow-up, several dilations of stenosis were required in five children. No recurrent tracheoesophageal fistula (TEF) was observed. There were no lethal outcomes.</p> Conclusion <p>Thoracoscopic repair of EA/TEF should be a procedure of choice for experienced endoscopic surgeons. It is a feasible and safe method useful also in low-birth-weight newborns and long-gap atresia with good results.</p>

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Experience with thoracoscopic esophageal atresia and tracheoesophageal fistula repair at a small volume centre

  • 期刊论文

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  • 发表日期：

    2025年3月1日

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  • Marián Molnár,
  • Barbora Špaková,
  • Matej Gura,
  • Andrii Pauk,
  • Michal Líška

摘要

Purpose

The early experience of thoracoscopic esophageal atresia and tracheoesophageal fistula (EA/TEF) repair at a small volume centre.

Methods

Eleven patients underwent thoracoscopic repair of esophageal atresia between 2018 and 2024. The gestational age ranged from 31 to 40 weeks, birth weight was 1360–3280 g. All were diagnosed postnatally. In ten cases, esophageal atresia (EA) with distal fistula was identified (Type C) and in one long-gap EA without fistula (Type A). Five newborns had associated malformations. Three ports technique was used, the fistula closure was performed by nonabsorbable suture or titanium clip. Interrupted suture was used for anastomosis and an 8-French chest tube was used.

Results

Twelve thoracoscopic procedures were performed in total. In the long-gap EA, an internal traction suture was applied at first and anastomosis was performed during the second operation. Conversion was necessary in two cases (loss of needle, endotracheal (ET) cannula dislocation). In one case, a colostomy was performed at the same time due to cloaca. Average operating time was 202 ± 68 min (range 120–340 min) and improved with gaining experience. The first esophagography was usually on the 8th day. Minimal anastomotic leak was observed in three patients. During 3–75 months of follow-up, several dilations of stenosis were required in five children. No recurrent tracheoesophageal fistula (TEF) was observed. There were no lethal outcomes.

Conclusion

Thoracoscopic repair of EA/TEF should be a procedure of choice for experienced endoscopic surgeons. It is a feasible and safe method useful also in low-birth-weight newborns and long-gap atresia with good results.