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.
July 07, 2022; Published: July 13, 2022
Introduction: In neonatal population, esophageal atresia with or without fistula is a rarer congenital anomaly having an incidence of 1/3000-5000 live births . 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
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