Thoracoscopic repair of tracheoesophageal fistulas: a case-control matched study

Introduction: To date, there is no comparative study of thoracoscopic repair (TR) vs conventional open repair (COR) for trachcoesophageal fistula (TEF). The aim of the study was to compare the 2 techniques in neonates with TER Methods: A multi-institutional case-control study of cases of TEF was undertaken. The minimum follow-up was 6 months. Patients were considered for TR based on surgeon's preference. Cases were frequency matched on a 1:1 ratio based on gestational age and weight. Outcomes of interest were operative time, postoperative leaks, and postoperative stricture development. Statistical analysis using univariate analysis was performed. Results: Twenty-three neonates underwent TR. There were no differences between TR and COR groups with regard to weight and gestational age. The distribution of associated anomalies was similar in both groups. The mean operative time was 149.4 and 179 minutes in TR and COR, respectively (P =.18). Three patients were converted to COR. There were 4 leaks in TR and 3 in COR (P =.728). Inversely, 2 patients in the TR group developed a stricture necessitating dilation as compared with 4 patients in the COR group (P =.414). Conclusion: Thoracoscopic repair of TEF is safe and comparable with conventional open repair. (C) 2008 Elsevier Inc. All rights reserved.