The application of stay sutures in thoracoscopic esophageal repair for Type C esophageal atresia.

IF 1.6 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2025-07-17 DOI:10.1007/s00383-025-06111-w

Shichun Zhu, Zhenyong Liu, Bing Li

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引用次数: 0

Abstract

Purpose: To investigate the clinical application of stay sutures in thoracoscopic repair for esophageal atresia (EA) combined with tracheoesophageal fistula (TEF).

Methods: A total of 56 neonates diagnosed with Type C EA received thoracoscopic correction surgery from May 2019 to December 2024. The patients were divided into 2 groups randomly: (1) Esophageal anastomosis was constructed using interrupted sutures on the posterior wall and continuous locked stitches on the anterior wall assisted by two stay sutures (Group A; n = 30) and (2) Esophageal anastomosis was performed using traditional techniques with interrupted sutures on both anterior and posterior walls (Group B; n = 26). A comprehensive comparison of operative parameters and postoperative complications was systematically conducted between the two surgical methods.

Results: The mean anastomotic time was significantly shorter in Group A (20.5 ± 3.3 min) compared with Group B (41.0 ± 4.5 min, P < 0.05). Similarly, operation time was 126.5 ± 15.5 min in Group A versus 154.5 ± 13.5 min in Group B (P < 0.05). Postoperative ventilator support duration was 2.1 ± 0.7 days in Group A versus 2.3 ± 0.6 days in Group B (P > 0.05). The time to first oral intake was 8.5 ± 1.8 days in Group A versus 9.3 ± 3.2 days in Group B (P > 0.05). An upper gastrointestinal series performed on postoperative day 5-7 revealed anastomotic leakage in 4 of 30 patients (13.3%) in Group A versus 6 of 26 patients (23.1%) in Group B (P > 0.05). Anastomotic stenosis was observed in 6 patients (20%) in Group A and 6 patients (23.1%) in Group B postoperatively, also with no statistically significant difference between the groups (P > 0.05). No recurrence of TEF was observed in each group.

Conclusion: This innovative approach significantly shortens the operative time in the thoracoscopic treatment of Type C EA.

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留置缝线在胸腔镜食管修复术中C型食管闭锁的应用。

目的：探讨留置缝线在胸腔镜下食管闭锁（EA）合并气管食管瘘（TEF）修复中的临床应用。方法：2019年5月至2024年12月，56例确诊为C型EA的新生儿接受胸腔镜矫正手术。将患者随机分为2组：(1)食管吻合采用后壁间断缝合和前壁连续缝合，并辅助两段留置缝合(A组；n = 30)和(2)采用传统的前后壁间断缝合技术进行食管吻合(B组；n = 26)。系统比较两种手术方式的手术参数及术后并发症。结果：A组平均吻合时间（20.5±3.3 min）明显短于B组（41.0±4.5 min, P < 0.05）。A组至首次口服时间为8.5±1.8 d， B组为9.3±3.2 d （P < 0.05）。A组30例患者中有4例（13.3%）出现吻合口漏，B组26例患者中有6例（23.1%）出现吻合口漏（P < 0.05）。A组术后吻合口狭窄6例（20%），B组术后吻合口狭窄6例（23.1%），组间差异无统计学意义（P < 0.05）。两组均未见TEF复发。结论：该创新入路明显缩短了胸腔镜治疗C型EA的手术时间。

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

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor