Short- and Long-Term Outcomes of Thoracoscopic and Open Repair for Esophageal Atresia and Tracheoesophageal Fistula

被引:2
作者
Yalcin, Sule [1 ]
Bhatia, Amina M. [1 ]
He, Zhulin [2 ]
Wulkan, Mark L. [1 ,3 ]
机构
[1] Emory Univ, Sch Med, Childrens Healthcare Atlanta, Div Pediat Surg,Dept Surg, Atlanta, GA USA
[2] Emory Univ, Sch Med, Dept Pediat, Biostat Core, Atlanta, GA USA
[3] Akron Childrens Hosp, Dept Surg, Akron, OH USA
关键词
Esophageal atresia; Tracheoesophageal fistula; Thoracoscopy; Open repair; Outcomes;
D O I
10.1016/j.jpedsurg.2024.08.002
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: The aim was to evaluate short- and long-term outcomes for thoracoscopic repair of EA/TEF and compare with open repair. Methods: Patients who underwent EA/TEF repair during 2000e2020 were evaluated retrospectively. Patients with delayed repair were excluded. Demographic, operative, outcome data was collected. Outcomes were compared using Wilcoxon-rank sum tests for continuous, Chi-squared/Fisher's exact tests for categorical data. Results: There were 104 patients with primary repair, 49 (47.1%) underwent thoracoscopic repair per surgeon's choice. Type C accounted for 101 (97.1%) of the cases. Gestational age and birth weight were higher in the thoracoscopy group (p = 0.001). The rate of >3 VACTERL anomalies was higher in the OR group (p = 0.016). Operative time, rate of anastomotic leak, time to first oral feeding were similar (p > 0.05). Thoracoscopy group had decreased length of ventilation (p = 0.026) and length of stay (p = 0.029). The incidence of anastomotic stricture was higher in the thoracoscopy group (p = 0.012). Recurrent TEF was one case in each group. Rates of tube feeding at discharge and in first year were similar (p > 0.05), rate in third year was decreased (p = 0.032) in the thoracoscopy group. Rates of antireflux medication in first and third years, and fundoplication rate were similar (p > 0.05). Conclusions: Many of the short- and long-term outcomes are comparable between thoracoscopic and open repair of EA/TEF. Length of ventilation, length of stay are decreased in the thoracoscopy group. Anastomotic stricture is higher, the need for long-term tube feeding is lower after thoracoscopic repair. Although these results could be affected by selection bias, they are still promising for advancing thoracoscopic repair of EA/TEF safely and efficiently. Level of Evidence: Level III. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
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页数:6
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