Journal of laparoendoscopic & advanced surgical techniques. Part A · 2026
Thoracoscopic Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula: Is It Safe to Delay Surgery?
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Ibarra Rodríguez Ignacio, Molino Gahete José Andrés, López Fernández Sergio, Martos Rodríguez Marta, Khan Haider Ali, Ruiz César Wenceslao, Estefania Karla, Vilardell Elena, Ribes Carmen, Guillén Gabriela
Аннотация
AIM OF THE STUDY: Thoracoscopic repair of esophageal atresia (EA) with distal tracheoesophageal fistula (TEF) is an increasingly adopted approach. However, it is a complex minimally invasive technique that should be performed by experienced surgeons under optimal conditions. This study aims to determine whether delaying surgery to ensure these conditions is safe.
METHODS: We conducted a retrospective observational study (2017 to 2024) analyzing historical cohorts of 41 neonates with EA and distal TEF who underwent thoracoscopic repair. Fifteen (36.5%) were operated on the first day of life (Group A), while 26 (63.5%) underwent delayed surgery (Group B). Baseline characteristics, preoperative and intraoperative morbidity and mortality, and follow-up outcomes were analyzed.
RESULTS: There were no significant differences in sex, gestational age, birth weight, or associated anomalies, including anorectal malformation. Group B neonates underwent surgery at 2.38 ± 0.76 days of life. No preoperative respiratory infections or need for emergency surgery were reported, and there were no significant differences in atelectasis (6.6% versus 11%), respiratory distress (40% versus 34%), or intubation requirement (13% versus 19%). Intraoperatively, conversion rates (6.6% versus 7.6%) and desaturation events (20% versus 19%) were comparable. Postoperatively, no differences were found in intubation days (3.3 versus 3.37), infections (6.6% versus 11.5%), atelectasis (13.3% versus 19.2%), or follow-up complications (P > .05).
CONCLUSIONS: Delaying the repair of EA with distal TEF is safe, allowing thoracoscopic surgery to be performed by experienced surgeons under optimal conditions without increasing morbidity due to the wait.
METHODS: We conducted a retrospective observational study (2017 to 2024) analyzing historical cohorts of 41 neonates with EA and distal TEF who underwent thoracoscopic repair. Fifteen (36.5%) were operated on the first day of life (Group A), while 26 (63.5%) underwent delayed surgery (Group B). Baseline characteristics, preoperative and intraoperative morbidity and mortality, and follow-up outcomes were analyzed.
RESULTS: There were no significant differences in sex, gestational age, birth weight, or associated anomalies, including anorectal malformation. Group B neonates underwent surgery at 2.38 ± 0.76 days of life. No preoperative respiratory infections or need for emergency surgery were reported, and there were no significant differences in atelectasis (6.6% versus 11%), respiratory distress (40% versus 34%), or intubation requirement (13% versus 19%). Intraoperatively, conversion rates (6.6% versus 7.6%) and desaturation events (20% versus 19%) were comparable. Postoperatively, no differences were found in intubation days (3.3 versus 3.37), infections (6.6% versus 11.5%), atelectasis (13.3% versus 19.2%), or follow-up complications (P > .05).
CONCLUSIONS: Delaying the repair of EA with distal TEF is safe, allowing thoracoscopic surgery to be performed by experienced surgeons under optimal conditions without increasing morbidity due to the wait.