Endoscope-assisted resection of second branchial cleft fistula via the anterior chest approach.

Objectives: Traditional resection of second branchial cleft fistulas (SBCFs) involves a transcervical incision in the neck, which leaves a prominent scar; therefore, endoscope-assisted excision of SBCFs through the anterior chest approach has been proposed. To introduce endoscope-assisted excision of SBCFs via the anterior chest approach and to evaluate its feasibility, validity, safety, and clinical results.

Methods: This was a study of four patients with SBCFs who underwent surgical resection with the assistance of endoscopy via the anterior chest approach between May 2012 and May 2018.

Results: All procedures were successfully performed with endoscope-assisted surgery via the anterior chest approach. The volume of blood loss ranged from 5 to 10 mL (median 6 ml). The operating time ranged from 45 to 67 min (median 50 min). No patients presented evidence of long-term complications or recurrence during the median follow-up period of 72-144 months (median 99 months). All patients were satisfied with the cosmetic outcomes.

Conclusions: Endoscope-assisted resection of SBCFs via the anterior chest approach is feasible, effective, and safe and has better esthetic effects. Therefore, SBCF surgery via the anterior chest approach could be a novel and superior treatment option for patients with SBCFs.