Thoracoscopic repair of esophageal atresia: Comparison with open approach

Background: The aim of the present study is to evaluate our initial experiences of thoracoscopic repair (TR) for esophageal atresia with/without trachoesophageal fistula (EA/TEF) and also to compare the results with open repair (OR). Subjects and Methods: Patients with EA/TEF who received surgeries...

Full description

Bibliographic Details
Main Authors: Chun-Hui Lin, Yih-Cherng Duh, Yu-Wei Fu, Yao-Jen Hsu, Chin-Hung Wei
Format: Article
Language:English
Published: Wolters Kluwer Health/LWW 2018-01-01
Series:Formosan Journal of Surgery
Subjects:
Online Access:http://www.e-fjs.org/article.asp?issn=1682-606X;year=2018;volume=51;issue=3;spage=105;epage=110;aulast=Lin
_version_ 1827850755931897856
author Chun-Hui Lin
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
author_facet Chun-Hui Lin
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
author_sort Chun-Hui Lin
collection DOAJ
description Background: The aim of the present study is to evaluate our initial experiences of thoracoscopic repair (TR) for esophageal atresia with/without trachoesophageal fistula (EA/TEF) and also to compare the results with open repair (OR). Subjects and Methods: Patients with EA/TEF who received surgeries in our institution between July 2009 and June 2015 were included in the study. The medical records were retrospectively reviewed. Patients are divided into two groups as follows: TR and OR. Parameters collected includes demographics, operation time, conversion, time to oral feeding, length of hospital stay, complications, and growth status. Statistical Analysis Used: Wilcoxon rank sum test, Chi-square, and Fisher's exact test. Results: A total of 21 patients with EA/TEF, 19 with type C and 2 with type A, were enrolled. There were 9 and 12 patients in TR and OR groups, respectively. There was no significant difference in demographics between both groups. Median operation time was significantly longer in TR (197.5 vs. 115 min, P < 0.01). The operations were converted in the initial three patients. In the following six patients, only one patient with pure EA required conversion. Median time to oral feeding was significantly longer in TR (12 vs. 7 days, P = 0.04). Anastomotic leakage occurred in three and one patients, respectively (33.3% vs. 8.3%, P = 0.27). Esophageal dilatation was required in 3 (33.3%) and 4 (33.3%) patients for esophageal stenosis in TR and OR groups, respectively (P = 0.999). Fundoplication was required in 2 (22.2%) and 3 (25%) patients of TR and OR groups, respectively (P = 1.00). Recurrent TEF developed in one patient (11.1%) of TR. The bodyweight fell behind 3 percentiles of the growth curve in 6 (66.7%) and 6 (50%) patients (P = 0.660). Conclusions: TR for EA/TEF is feasible. The initial experiences revealed longer operation time and higher complication rate compared to OR.
first_indexed 2024-03-12T10:23:08Z
format Article
id doaj.art-e8f31e2383dd49cc9e662a85550b3bed
institution Directory Open Access Journal
issn 1682-606X
language English
last_indexed 2024-03-12T10:23:08Z
publishDate 2018-01-01
publisher Wolters Kluwer Health/LWW
record_format Article
series Formosan Journal of Surgery
spelling doaj.art-e8f31e2383dd49cc9e662a85550b3bed2023-09-02T09:59:05ZengWolters Kluwer Health/LWWFormosan Journal of Surgery1682-606X2018-01-0151310511010.4103/fjs.fjs_145_17Thoracoscopic repair of esophageal atresia: Comparison with open approachChun-Hui LinYih-Cherng DuhYu-Wei FuYao-Jen HsuChin-Hung WeiBackground: The aim of the present study is to evaluate our initial experiences of thoracoscopic repair (TR) for esophageal atresia with/without trachoesophageal fistula (EA/TEF) and also to compare the results with open repair (OR). Subjects and Methods: Patients with EA/TEF who received surgeries in our institution between July 2009 and June 2015 were included in the study. The medical records were retrospectively reviewed. Patients are divided into two groups as follows: TR and OR. Parameters collected includes demographics, operation time, conversion, time to oral feeding, length of hospital stay, complications, and growth status. Statistical Analysis Used: Wilcoxon rank sum test, Chi-square, and Fisher's exact test. Results: A total of 21 patients with EA/TEF, 19 with type C and 2 with type A, were enrolled. There were 9 and 12 patients in TR and OR groups, respectively. There was no significant difference in demographics between both groups. Median operation time was significantly longer in TR (197.5 vs. 115 min, P < 0.01). The operations were converted in the initial three patients. In the following six patients, only one patient with pure EA required conversion. Median time to oral feeding was significantly longer in TR (12 vs. 7 days, P = 0.04). Anastomotic leakage occurred in three and one patients, respectively (33.3% vs. 8.3%, P = 0.27). Esophageal dilatation was required in 3 (33.3%) and 4 (33.3%) patients for esophageal stenosis in TR and OR groups, respectively (P = 0.999). Fundoplication was required in 2 (22.2%) and 3 (25%) patients of TR and OR groups, respectively (P = 1.00). Recurrent TEF developed in one patient (11.1%) of TR. The bodyweight fell behind 3 percentiles of the growth curve in 6 (66.7%) and 6 (50%) patients (P = 0.660). Conclusions: TR for EA/TEF is feasible. The initial experiences revealed longer operation time and higher complication rate compared to OR.http://www.e-fjs.org/article.asp?issn=1682-606X;year=2018;volume=51;issue=3;spage=105;epage=110;aulast=LinEsophageal atresiatracheoesophageal fistulaesophageal dysmotilitythoracoscopy
spellingShingle Chun-Hui Lin
Yih-Cherng Duh
Yu-Wei Fu
Yao-Jen Hsu
Chin-Hung Wei
Thoracoscopic repair of esophageal atresia: Comparison with open approach
Formosan Journal of Surgery
Esophageal atresia
tracheoesophageal fistula
esophageal dysmotility
thoracoscopy
title Thoracoscopic repair of esophageal atresia: Comparison with open approach
title_full Thoracoscopic repair of esophageal atresia: Comparison with open approach
title_fullStr Thoracoscopic repair of esophageal atresia: Comparison with open approach
title_full_unstemmed Thoracoscopic repair of esophageal atresia: Comparison with open approach
title_short Thoracoscopic repair of esophageal atresia: Comparison with open approach
title_sort thoracoscopic repair of esophageal atresia comparison with open approach
topic Esophageal atresia
tracheoesophageal fistula
esophageal dysmotility
thoracoscopy
url http://www.e-fjs.org/article.asp?issn=1682-606X;year=2018;volume=51;issue=3;spage=105;epage=110;aulast=Lin
work_keys_str_mv AT chunhuilin thoracoscopicrepairofesophagealatresiacomparisonwithopenapproach
AT yihcherngduh thoracoscopicrepairofesophagealatresiacomparisonwithopenapproach
AT yuweifu thoracoscopicrepairofesophagealatresiacomparisonwithopenapproach
AT yaojenhsu thoracoscopicrepairofesophagealatresiacomparisonwithopenapproach
AT chinhungwei thoracoscopicrepairofesophagealatresiacomparisonwithopenapproach