Birth weight and thoracoscopic approach for patients with esophageal atresia and tracheoesophageal fistula-a retrospective cohort study.

Autor: Borselle D; Department of Pediatric Surgery and Urology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland. dominika.borselle@umw.edu.pl., Gerus S; Department of Pediatric Surgery and Urology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland., Bukowska M; Department of Pediatric Surgery and Urology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland., Patkowski D; Department of Pediatric Surgery and Urology, Wroclaw Medical University, Borowska 213, 50-556, Wroclaw, Poland.
Jazyk: angličtina
Zdroj: Surgical endoscopy [Surg Endosc] 2024 Sep; Vol. 38 (9), pp. 5076-5085. Date of Electronic Publication: 2024 Jul 17.
DOI: 10.1007/s00464-024-11063-8
Abstrakt: Background: This study aimed to analyze the results, feasibility and safety of the thoracoscopic approach for patients with esophageal atresia with tracheoesophageal fistula (EA/TEF) depending on the patient's birth weight.
Methods: The study involved only type C and D EA/TEF. Among the analyzed parameters were the patients' characteristics, surgical treatment and post-operative complications: early mortality, anastomosis leakage, anastomosis strictures, chylothorax, TEF recurrence, and the need for fundoplication or gastrostomy.
Results: 145 consecutive newborns underwent thoracoscopic EA with TEF repair. They were divided into three groups-A (N = 12 with a birth weight < 1500 g), B (N = 23 with a birth weight ≥ 1500 g but < 2000 g), and C-control group (N = 110 with a birth weight ≥ 2000 g). Primary one-stage anastomosis was performed in 11/12 (91.7%) patients-group A, 19/23 (82.6%)-group B and 110 (100%)-group C. Early mortality was 3/12 (25%)-group A, 2/23 (8.7%)-group B, and 2/110 (1.8%)-group C and was not directly related to the surgical repair. There were no significant differences in operative time and the following complications: anastomotic leakage, recurrent TEF, esophageal strictures, and chylothorax. There were no conversions to an open surgery. Fundoplication was required in 0%-group A, 4/21 (19.0%)-group B, and 2/108 (1.9%)-group C survivors. Gastrostomy was performed in 1/9 (11.1%)-group A, 3/21 (14.3%)-group B and 0%-group C.
Conclusion: In an experienced surgeon's hands, even in the smallest newborns, the thoracoscopic approach may be safe, feasible, and worthy of consideration. Birth weight seems to be not a direct contraindication to the thoracoscopic approach.
(© 2024. The Author(s).)
Databáze: MEDLINE
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