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Short- and Long-Term Outcomes of Thoracoscopic and Open Repair For Esophageal Atresia and Tracheoesophageal Fistula.
Yalcin, Sule; Bhatia, Amina M; He, Zhulin; Wulkan, Mark L.
Afiliación
  • Yalcin S; Division of Pediatric Surgery, Department of Surgery, Emory University, School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
  • Bhatia AM; Division of Pediatric Surgery, Department of Surgery, Emory University, School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
  • He Z; Department of Pediatrics, Biostatistics Core, Emory University School of Medicine, Atlanta, GA, USA.
  • Wulkan ML; Division of Pediatric Surgery, Department of Surgery, Emory University, School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA; Department of Surgery, Akron Children's Hospital, Akron, OH, USA. Electronic address: mlwulkan@gmail.com.
J Pediatr Surg ; : 161662, 2024 Aug 05.
Article en En | MEDLINE | ID: mdl-39218728
ABSTRACT

BACKGROUND:

The aim was to evaluate short- and long-term outcomes for thoracoscopic repair of EA/TEF and compare with open repair.

METHODS:

Patients who underwent EA/TEF repair during 2000-2020 were evaluated retrospectively. Patients with delayed repair were excluded. Demographic, operative, outcome data was collected. Outcomes were compared using Wilcoxon-rank sum tests for continuous, Chi-squared/Fisher's exact tests for categorical data.

RESULTS:

There were 104 patients with primary repair, 49 (47.1%) underwent thoracoscopic repair per surgeon's choice. Type C accounted for 101 (97.1%) of the cases. Gestational age and birth weight were higher in the thoracoscopy group (p = 0.001). The rate of ≥3 VACTERL anomalies was higher in the OR group (p = 0.016). Operative time, rate of anastomotic leak, time to first oral feeding were similar (p > 0.05). Thoracoscopy group had decreased length of ventilation (p = 0.026) and length of stay (p = 0.029). The incidence of anastomotic stricture was higher in the thoracoscopy group (p = 0.012). Recurrent TEF was one case in each group. Rates of tube feeding at discharge and in first year were similar (p > 0.05), rate in third year was decreased (p = 0.032) in the thoracoscopy group. Rates of anti-reflux medication in first and third years, and fundoplication rate were similar (p > 0.05).

CONCLUSIONS:

Many of the short- and long-term outcomes are comparable between thoracoscopic and open repair of EA/TEF. Length of ventilation, length of stay are decreased in the thoracoscopy group. Anastomotic stricture is higher, the need for long-term tube feeding is lower after thoracoscopic repair. Although these results could be affected by selection bias, they are still promising for advancing thoracoscopic repair of EA/TEF safely and efficiently. LEVEL OF EVIDENCE Level III.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pediatr Surg Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos