A comparative study of thoracoscopic and open tracheoesophageal fistula and esophageal atresia repair as first single center experience in Turkey

摘要

Abstract Purpose The focus of esophageal atresia treatment is now on reducing hospitalization and common morbidities and to prevent complications such as anastomotic leak and esophageal stricture formation. The objective of this study was to compare the perioperative and postoperative outcome measures such as operation times, anastomotic leak and stricture formation in children who underwent thoracoscopic and open repair of esophageal atresia/tracheoesophageal fistula as newborns in a single institution.Methods Children who underwent surgery for esophageal atresia/tracheoesophageal fistula between 2014 and 2020 were enrolled to the study. Charts of patients were reviewed retrospectively for demographic and perioperative data. Postoperative outcome endpoints such as stricture formation rates, anastomotic leak more than 1 week, and of the chest tube were compared.Results There were 22 children in the study, of which 14 underwent thoracoscopic repair and 8 underwent open repair. Both groups were similar in terms of gestational age, birth weight and associated major anomalies. Operative times were similar (thoracoscopic repair: 169 and open repair: 175 min). Stricture formation was observed in three children in thoracoscopic group (21%) and four children in open group (50%). Anastomotic leak persisted for more than a week in three children in thoracoscopic group (25%) and two in open group (25%). Stricture rates and anastomotic leak for more than one week rates were statistically similar between groups. The azygous veins were preserved in 11 of 14 children in thoracoscopic group while none in the eight children that were operated in open group.Conclusion Thoracoscopic repair is comparative to open repair regarding operative time and postoperative outcome endpoints such as esophageal stricture formation and anastomotic leak more than 1 week in the study. Thoracoscopic repairs are as feasible as open repairs with the advantage of preserving the azygos vein.