Clinical challenges and outcomes of thoracoscopic versus open repair in esophageal atresia: a single-center retrospective comparative study.

IF 1.2 4区医学 Q3 SURGERY

Annals of Surgical Treatment and Research Pub Date : 2025-06-01 Epub Date: 2025-06-02 DOI:10.4174/astr.2025.108.6.390

Dayoung Ko, Ji-Hyun Lee, Joong Kee Youn, Hyun-Young Kim

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Abstract

Purpose: This study aimed to compare clinical outcomes between thoracoscopic surgery (TR) and open surgery (OR) for esophageal atresia with distal tracheoesophageal fistula (EA with distal TEF) and to evaluate the feasibility of TR.

Methods: We retrospectively analyzed the clinical data of 42 patients who underwent primary surgery for EA with distal TEF from January 2012 to December 2020. We compared the OR and TR groups based on patient characteristics, intraoperative outcomes, and early and late postoperative outcomes.

Results: The TR group had longer operation times and a higher risk for intraoperative hypoxic events. Anastomosis leakage and stricture tended to occur more frequently in the TR group, although not statistically significant. The TR group required a significantly higher number of esophageal balloon dilatations (P = 0.006).

Conclusion: Successful TR for EA with distal TEF requires advanced anesthesia and efforts to overcome the learning curve of surgical skill with limited thoracoscopic instruments for neonates. Despite challenges, TR is considered a feasible method for EA with distal TEF patients when performed by experienced pediatric surgeons with appropriate anesthesia support.

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食管闭锁胸腔镜与开放式修复的临床挑战和结果：一项单中心回顾性比较研究。

目的：本研究旨在比较胸腔镜手术（TR）与开放手术（OR）治疗食管闭锁伴远端气管食管瘘（EA伴远端TEF）的临床效果，并评估开放手术（OR）的可行性。方法：回顾性分析2012年1月至2020年12月收治的42例食管闭锁伴远端气管食管瘘初次手术患者的临床资料。我们根据患者特征、术中结果、术后早期和晚期结果比较了OR组和TR组。结果：TR组手术时间较长，术中缺氧事件发生风险较高。吻合口漏及狭窄在TR组发生率更高，但无统计学意义。TR组食管球囊扩张次数显著高于对照组（P = 0.006）。结论：成功的TR治疗远端TEF的EA需要先进的麻醉和努力克服手术技能的学习曲线，在有限的胸腔镜器械下为新生儿。尽管存在挑战，但当经验丰富的儿科外科医生在适当的麻醉支持下进行手术时，TR被认为是治疗远端TEF患者EA的可行方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Surgical Treatment and Research SURGERY-

CiteScore

2.30

自引率

7.10%

发文量

期刊介绍： Manuscripts to the Annals of Surgical Treatment and Research (Ann Surg Treat Res) should be written in English according to the instructions for authors. If the details are not described below, the style should follow the Uniform Requirements for Manuscripts Submitted to Biomedical Journals: Writing and Editing for Biomedical Publications available at International Committee of Medical Journal Editors (ICMJE) website (http://www.icmje.org).