Acta Scientific Paediatrics (ISSN: 2581-883X)

Research Article Volume 5 Issue 8

Feasibility of Oesophageal Atresia and Distal Tracheoesophageal Fistula Repair by Thoracoscopic Method

Ali Raza Brohi*, Naseem Mengal and Zubair Ahmed

Department of Pediatric Surgery, Peoples University of Medical and Health Science, Nawabshah, Sind, Pakistan

*Corresponding Author: Ali Raza Brohi, Department of Pediatric Surgery, Peoples University of Medical and Health Science, Nawabshah, Sind, Pakistan.

Received: July 07, 2022; Published: July 13, 2022

Abstract

Introduction: In neonatal population, esophageal atresia with or without fistula is a rarer congenital anomaly having an incidence of 1/3000-5000 live births [1]. Traditionally it was repaired by posterolateral thoracotomy but this approach is associated with musculoskeletal morbidity. Since the first repair, made the paediatric surgeons confident then they started to bring refinements in their techniques, and led to adoption of this technique in many institutions worldwide.

Material and Methods: This is retrospective study conducted from June 2015 to June 2021 in pediatric surgery department at Peoples University of medical and health sciences Nawabshah Sind, Pakistan. We reviewed the medical records of 85 patients who underwent thoracoscopic esophageal atresia. Data collected included newborn age and weight at the time of surgery, operative time, days of hospitalization, time to start first feed and post-op complications.

Results: Total 85 patients were operated thoracoscopically having mean age at the time of surgery was 3 days because most of patients coming late in our hospital and mostly they are diagnosed postnatally. Weight of patients at the time of surgery ranges between 1.5-3.5kg. Contrast swallow post operatively done in all case on day 5 out of which in 15 (18%) cases leak was confirmed and majority heal spontaneously in 10 -15 days.

Conclusion: Thoracoscopic primary repair of esophageal atresia with distal fistula is feasible then open thoracotomy in terms of visualization of structures, advancement in instruments and refinements in technique to prevent high rate of complications.

Keywords: Oesophageal; Tracheoesophageal; Fistula; Thoracoscopic

References

  1. Rothenberg SS. “Thoracoscopic repair of esophageal atresia and tracheoesophageal fistula in neonate, Evolution of technique”. Journal of Laparoendoscopic and Advanced Surgical Techniques 2 (2012): 195-199.
  2. Freeman NV and Walkden J. “Previously unreported shoulder deformity following right lateral thoracotomy for esophageal atresia”. Journal of Pediatric Surgery 6 (1969): 627-636.
  3. Durning RP., et al. “Scoliosis after thoracotomy in tracheoesophageal fistula patient. A follow-up study”. The Journal of Bone and Joint Surgery. American 7 (1980): 1156-1159.
  4. Cherup LL., et al. “Breast and pectoral muscle maldevelopment after anterolateral and posterolateral thoracotomies in children”. The Annals of Thoracic Surgery 5 (1986): 492-497.
  5. Lobe TE., et al. “Thoracoscopic repair of esophageal atresia in an infant: A surgical first”. Pediatric Endosurgery and Innovative Techniques3 (1999): 141-148.
  6. Augusto Z., et al. “International survey on the management of esophageal atresia”. European Journal of Pediatric Surgery 1 (2014): 3-8.
  7. Lal D., et al. “Current patterns of practice and technique in the repair of esophageal atresia fistula: Basics of technique and its nuances”. Journal of Indian Association of Pediatric Surgeons 3 (2013): 120-124.
  8. Hassan ME and Khalid Al Ali. “First thoracoscopic repair of tracheoesophageal fistula in UAE: a case report and review of literature”. Annals of Pediatric Surgery 2 (2014): 46-49.
  9. and tracheoesophageal fistua: an IPEG survey”. Journal of Laparoendoscopic and Advanced Surgical Techniques A 7 (2012): 635-638.
  10. Yamoto M., et al. “Thoracoscopic versus open repair of esophageal atresia with tracheoesophageal fistula at a single institution”. Pediatric Surgery International 9 (2014): 883-887.
  11. Brohi AR., et al. “Thoracoscopic esophageal atresia repair in Pakistan: early learning curve”. Journal of Neonatal Surgery 4 (2017): 78.
  12. Rothenberg SS. “Thoracoscopic repair of esophageal atresia andtracheo-esophageal fistula”. In Seminars in pediatric surgery 14.1 (2005): 2-7.
  13. Iacona RV and Saxena AK. “Thoracoscopic repair of esophageal atresia with distal tracheoesophageal fistula (Type C): systematic review”. Surgical Laparoscopy Endoscopy and Percutaneous Techniques4 (2020): 388-393.
  14. Koivusalo AI., et al. “Modern outcomes of oesophageal atresia: single centre experience over the last twenty years”. Journal of Pediatric Surgery2 (2013): 297-303.
  15. Sharma S., et al. “Azygos vein preservation in primary repair of esophageal atresia with tracheoesophageal fistula”. Pediatric Surgery International12 (2007): 1215-1218.
  16. Thyoka M., et al. “Fluoroscopic balloon dilation of esophageal atresia anastomotic strictures in children and young adults: single-center study of 103 consecutive patients from 1999 to 2011”. Radiology 2 (2014): 596-601.
  17. Tovar JA and Fragoso AC. “Anti-reflux surgery for patients with esophageal atresia”. Diseases of the Esophagus4 (2013): 401-404.
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Citation

Citation: Ali Raza Brohi., et al. “Feasibility of Oesophageal Atresia and Distal Tracheoesophageal Fistula Repair by Thoracoscopic Method". Acta Scientific Paediatrics 5.8 (2022): 07-11.

Copyright

Copyright: © 2022 Ali Raza Brohi., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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Impact Factor1.197

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