Thoracoscopic Repair of Esophageal Atresia With Distal Tracheoesophageal Fistula (Type C): Systematic Review

2020 ◽  
Vol 30 (4) ◽  
pp. 388-393 ◽  
Author(s):  
Roberta V. Iacona ◽  
Amulya K. Saxena
Keyword(s):  
Systematic Review ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Thoracoscopic Repair ◽  
Type C

DOZ047.82: Outcome of thoracoscopic repair of type C esophageal atresia: single-center experience from North Africa

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
M Elbarbary ◽  
A Shalaby ◽  
M Elseoudi ◽  
M Ragab ◽  
A E Fares ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Esophageal Atresia ◽  
Operative Time ◽  
Primary Anastomosis ◽  
Single Center Experience ◽  
Resource Setting ◽  
Thoracoscopic Repair ◽  
Type C ◽  
The Mean ◽  
A Prospective Study

Abstract Background and Aim Thoracoscopic repair of esophageal atresia is gaining popularity worldwide owing to the availability of and advances in minimally invasive instruments. This report presents our early experience of thoracoscopic esophageal atresia repair (EA/TEF) in a single institute. Methods A prospective study on short-gap type C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital from April 2016. The technique was standardized in all cases: patients placed in the fully prone position, and using a 5 mm 30° scope with 3 mm instruments and carried out by four experts in minimally invasive surgery. Data was collected to include patient demographics and operative time. The main outcome was survival. Secondary outcomes were leak rate and postoperative stricture. Results Over a period of 24 months (April 2016–April 2018) 136 cases of EA/TEF were admitted. Thoracoscopy was attempted in 76 cases. Thirty cases with pure atresia or long-gap anomaly were excluded from this study for gap length, leaving 46 (60%) nonconsecutive neonates who underwent thoracoscopic repair of their short-gap EA/TEF. Five cases (10.8%) were converted to open surgery via right thoracotomy. A primary anastomosis was possible in all cases, leaving the azygos intact. The mean age at operation was 8.7 days (range 2–32), the mean weight was 2.6 kg (range 1.8–3.6), and the mean operative time was 108.3 minutes (range 80–180). In the fully thoracoscopic patients the survival was 85.4% (n = 35). An anastomotic leak occurred in 17% (n = 7); it was managed conservatively in 2 and with esophagostomy and gastrostomy in 5 cases. Followup was at one week, one and three months postdischarge. A stricture developed in 5 (16.6%) of the 30 surviving patients who kept their native esophagus. Conclusions Thoracoscopic repair is a feasible alternative even in a low-resource setting. The better outcome compared to traditional open repair in our center may be due to patient selection bias.

scholarly journals Clinical Comparison Between Thoracoscopic and Thoracotomy Repair of Gross Type C Esophageal Atresia

2021 ◽  
Author(s):  
Shen Yang ◽  
Peize Wang ◽  
Zhi Yang ◽  
Siqi Li ◽  
Junmin Liao ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Anastomotic Leakage ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Operative Time ◽  
Anastomotic Stricture ◽  
Surgical Approaches ◽  
Invasive Technique ◽  
Thoracoscopic Approach ◽  
Type C

Abstract Background To compare the clinical outcomes between thoracoscopic approach and thoracotomy surgery in patients with Gross type C Esophageal atresia (EA) and tracheoesophageal fistula (TEF). Methods Patients with Gross type C EA/TEF who underwent surgery from January 2007 to January 2020 at Beijing Children’s Hospital were retrospectively analyzed. The patients were divided into 2 groups according to surgical approaches. The perioperative factors and postoperative complications were compared among the 2 groups. Results One hundred and ninety patients (132 boys and 58 girls) with a median birth weight of 2975 (2600, 3200) g were included. The primary operations were performed via thoracoscopic (n = 62) and thoracotomy (n = 128) approach. After comparison of clinical characteristics between the 2 groups, we found that there were statistically significant differences in associated anomalies, method of fistula closure, duration of mechanical ventilation after surgery, feeding option before discharge, management of pneumothorax, and prognosis (all P < 0.05). To a certain extent, thoracoscopic surgery reduced the incidence of anastomotic leakage and increased the incidence of anastomotic stricture in this study. However, there were no statistically significant differences between the 2 groups in terms of operative time, postoperative pneumothorax, anastomotic leakage, anastomotic stricture, and recurrent tracheoesophageal fistula (all P > 0.05). Conclusions Thoracoscopy surgery for Gross type C EA/TEF is a safe and effective, minimally invasive technique with comparable operative time and incidence of postoperative complications.

scholarly journals Crossover Upper Pouch in Type C Esophageal Atresia: An Uncommon Variant Causing Diagnostic Dilemma

2018 ◽  
Vol 7 (2) ◽  
pp. 23
Author(s):  
Shailesh Solanki ◽  
Ravi Prakash Kanojia ◽  
Ram Samujh
Keyword(s):  
Congenital Anomaly ◽  
Early Diagnosis ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Morbidity And Mortality ◽  
Diagnostic Dilemma ◽  
Significant Length ◽  
Type C

Esophageal atresia with tracheoesophageal fistula (EA-TEF) is a well-known congenital anomaly and Type C variety of gross classification is the most common. Even for Type C variety, anatomy of upper pouch and lower pouch is not always the same. We are presenting three cases of Type C EA-TEF with unusual anatomy. In this type, upper pouch crosses over the lower pouch for a significant length. The cases are described here to highlight this variant of Type C EA-TEF which produces diagnostic dilemma. An early diagnosis of this variant, prevents morbidity and mortality.

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