Journal of pediatric surgery · 2025
Clinical outcomes of primary thoracoscopic repair in patients with esophageal atresia and tracheoesophageal fistula: A multicenter study from the East Asia pediatric surgery research consortium.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Tsuruno Yudai, Sugita Koshiro, Ota Kazuki, Fung Adrian Chi Heng, Shigeta Yusuke, Deie Kyoichi, Onishi Shun, Chan Ivy Hau Yee, Takezoe Toshiko, Miyake Yuichiro, Tsutsuno Takashi, Shibuya Soichi, Chung Patrick Ho Yu, Shirota Chiyoe, Tainaka Takahisa, Miyano Go, Kawashima Hiroshi, Wong Kenneth Kak Yuen, Uchida Hiroo, Ieiri Satoshi
Аннотация
PURPOSE: Thoracoscopic repair for esophageal atresia/tracheoesophageal fistula (EA/TEF) has not been widely adopted despite its introduction nearly 25 years ago. We reviewed the clinical outcomes of primary thoracoscopic EA/TEF repair performed at 5 leading centers for minimally invasive pediatric surgery in East Asia.
METHODS: A retrospective review was conducted of patients with EA/TEF (Gross type C) who underwent primary thoracoscopic repair between 2008 and 2024. Patients with Gross type A/B/D/E, long-gap EA requiring staged repair, or trisomy18 were excluded. Collected data included demographics, surgical outcomes, and long-term outcomes.
RESULTS: A total of 127 patients underwent thoracoscopic repair for EA/TEF during the study period. The mean gestational age, birth weight, and age at surgery were 38 ± 2.1 weeks, 2540 ± 487 g, and 3.0 ± 7.5 days, respectively. Thirty patients (23.6 %) had cardiac anomalies, and 8 (6.3 %) had chromosomal anomalies (excluding trisomy18). The mean operative time and intraoperative blood loss were 191 ± 67 min and 4.3 ± 8.7 mL, respectively. Nine patients (7.1 %) required conversion to open surgery and 10 (7.9 %) required blood transfusions. The mean length of hospitalization was 74 ± 73 days. Postoperative complications included anastomotic leak in 8 (6.3 %) patients and chylothorax in 9 (7.1 %). The long-term outcomes included anastomotic stenosis requiring dilatation in 52 patients (41.6 %), gastroesophageal reflux (GER) in 49 patients (39.2 %), and recurrent TEF in 3 (2.4 %). Mortality case was recognized in 2 (1.6 %).
CONCLUSION: The results of this study indicate that thoracoscopic repair for EA/TEF is a safe procedure when performed on selected patients and in centers with suitable thoracoscopic experience.
METHODS: A retrospective review was conducted of patients with EA/TEF (Gross type C) who underwent primary thoracoscopic repair between 2008 and 2024. Patients with Gross type A/B/D/E, long-gap EA requiring staged repair, or trisomy18 were excluded. Collected data included demographics, surgical outcomes, and long-term outcomes.
RESULTS: A total of 127 patients underwent thoracoscopic repair for EA/TEF during the study period. The mean gestational age, birth weight, and age at surgery were 38 ± 2.1 weeks, 2540 ± 487 g, and 3.0 ± 7.5 days, respectively. Thirty patients (23.6 %) had cardiac anomalies, and 8 (6.3 %) had chromosomal anomalies (excluding trisomy18). The mean operative time and intraoperative blood loss were 191 ± 67 min and 4.3 ± 8.7 mL, respectively. Nine patients (7.1 %) required conversion to open surgery and 10 (7.9 %) required blood transfusions. The mean length of hospitalization was 74 ± 73 days. Postoperative complications included anastomotic leak in 8 (6.3 %) patients and chylothorax in 9 (7.1 %). The long-term outcomes included anastomotic stenosis requiring dilatation in 52 patients (41.6 %), gastroesophageal reflux (GER) in 49 patients (39.2 %), and recurrent TEF in 3 (2.4 %). Mortality case was recognized in 2 (1.6 %).
CONCLUSION: The results of this study indicate that thoracoscopic repair for EA/TEF is a safe procedure when performed on selected patients and in centers with suitable thoracoscopic experience.