scholarly journals Thoracoscopic Esophageal Atresia Repair in Pakistan: Early Learning Curve

2017 ◽  
Vol 6 (4) ◽  
pp. 78 ◽  
Author(s):  
Ali Raza Brohi ◽  
Naseem Mengal ◽  
Rafia Tabassum
Keyword(s):  
Learning Curve ◽  
Esophageal Atresia ◽  
Single Incision ◽  
Single Layer ◽  
Early Learning ◽  
Esophageal Leak ◽  
Open Thoracotomy ◽  
Initial Learning ◽  
Thoracoscopic Repair ◽  
Type C

Background: Esophageal atresia is rare congenital anomaly, which is traditionally repaired by open thoracotomy. Thoracoscopic esophageal atresia repair has evolved as an effective and safe technique.Material and Methods: This is a retrospective review of 11 cases of esophageal atresia (type C), between June 2015 to May 2016. The objective of study is to describe our initial learning curve of thoracoscopic esophageal atresia repair.Results: Out of 11 patients, initial 4 underwent video assisted technique through single incision of 2 cm to visualize the exact video-scopic anatomy and to do few steps if possible. In last 7 cases, steps were completed with both ends mobilization and intracorporeally single layer interrupted stitching of esophagus. Complications encountered in 3 patients like esophageal leak in one managed conservatively, stenosis and reflux in one patient each.Conclusion: Thoracoscopic esophageal atresia repair is challenging and demanding surgery. Every surgeon has a learning curve before successful thoracoscopic repair which requires skills and learning under supervision of experienced surgeons.

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 Learning Curve of Thoracoscopic Repair of Esophageal Atresia

2012 ◽  
Vol 36 (9) ◽  
pp. 2093-2097 ◽  
Author(s):  
David C. van der Zee ◽  
Stefaan H. A. J. Tytgat ◽  
Sander Zwaveling ◽  
Maud Y. A. van Herwaarden ◽  
Daisy Vieira-Travassos
Keyword(s):  
Learning Curve ◽  
Esophageal Atresia ◽  
Thoracoscopic Repair

scholarly journals Respiratory morbidity and growth after open thoracotomy or thoracoscopic repair of esophageal atresia

2012 ◽  
Vol 47 (11) ◽  
pp. 1975-1983 ◽  
Author(s):  
Marjolein Spoel ◽  
Conny J.H.M. Meeussen ◽  
Saskia J. Gischler ◽  
Wim C.J. Hop ◽  
Nikolaas M.A. Bax ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Respiratory Morbidity ◽  
Open Thoracotomy ◽  
Thoracoscopic Repair

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

2020 ◽  
Vol 33 (7) ◽  
Author(s):  
Mohamed M Elbarbary ◽  
Aly Shalaby ◽  
Mohamed Elseoudi ◽  
Hamed M Seleim ◽  
Moutaz Ragab ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Anastomotic Leakage ◽  
Esophageal Atresia ◽  
Operative Time ◽  
Anastomotic Stricture ◽  
Primary Anastomosis ◽  
Tertiary Care ◽  
Thoracoscopic Approach ◽  
Thoracoscopic Repair ◽  
Type C

Summary Thoracoscopic repair of esophageal atresia is gaining popularity worldwide attributable to availability and advances in minimally invasive instruments. In this report, we presented our experience with thoracoscopic esophageal atresia/tracheoesophageal fistula (EA/TEF) repair in our tertiary care institute. A prospective study on short-gap type-C EA/TEF was conducted at Cairo University Specialized Pediatric Hospital between April 2016 and 2018. Excluded were cases with birth weight < 1500 gm, inability to stabilize physiologic parameters, or major cardiac anomalies. The technique was standardized in all cases and was carried out by operating team concerned with minimally invasive surgery at our facility. Primary outcome evaluated was successful primary anastomosis. Secondary outcomes included operative time, conversion rate, anastomotic leakage, recurrent fistula, postoperative stricture, and time till discharge. Over the inclusion period of this study, 136 cases of EA/TEF were admitted at our surgical NICU. Thoracoscopic repair was attempted in 76 cases. In total, 30 cases were pure atresia/long gap type-C atresia and were excluded from the study. Remaining 46 cases met the inclusion criteria and were enrolled in the study. Mean age at operation was 8.7 days (range 2–32), and mean weight was 2.6 Kg (range 1.8–3.6). Apart from five cases (10.8%) converted to thoracotomy, the mean operative time was 108.3 minutes (range 80–122 minute). A tension-free primary anastomosis was possible in all thoracoscopically managed cases (n = 41) cases. Survival rate was 85.4% (n = 35). Anastomotic leakage occurred in seven patients (17%). Conservative management was successful in two cases, while esophagostomy and gastrostomy were judged necessary in the other for five. Anastomotic stricture developed in five cases (16.6%) of the 30 surviving patients who kept their native esophagus. Despite the fact that good mid-term presented results may be due to patient selection bias, thoracoscopic approach proved to be feasible for management of short-gap EA/TEF. Authors of this report believe that thoracoscopy should gain wider acceptance and pediatric surgeons should strive to adopt this procedure.

scholarly journals Thoracoscopic Esophageal Atresia with Tracheoesophageal Fistula Repair: The First Iranian Group Report, Passing the Learning Curve

2016 ◽  
Vol 5 (3) ◽  
pp. 29 ◽  
Author(s):  
Mehran Hiradfar ◽  
Mohammad Gharavifard ◽  
Reza Shojaeian ◽  
Marjan Joodi ◽  
Reza Nazarzadeh ◽  
...  
Keyword(s):  
Learning Curve ◽  
Esophageal Atresia ◽  
Conversion Rate ◽  
Tracheoesophageal Fistula ◽  
Point Of View ◽  
Thoracoscopic Approach ◽  
First Case ◽  
Thoracoscopic Repair ◽  
Esophageal Anastomosis ◽  
Overall Mortality

Background: Thoracoscopic treatment of esophageal atresia and tracheoesophageal fistula (EA+TEF) is accepted as a superior technique at least in cosmetic point of view but it is considered as an advance endoscopic procedure that needs a learning curve to be performed perfectly. This is the first report of Iranian group pediatric surgeons in thoracoscopic approach to EA.Methods & Materials: Since 2010, twenty four cases with EA+TEF underwent thoracoscopic approach in Sarvar children Hospital (Mashhad -Iran). During the first 6 months, thoracoscopic approach to 6 cases of EA+TEF was converted to open procedure because of technical and instrumental problems. The first case of successful thoracoscopic EA repair was accomplished in 2010 and since then, 10 cases of EA+ TEF among 18 patients were treated successfully with thoracoscopic approachResults: Overall conversion rate was 58.3% but conversion rate after the primary learning curve period, was 35.7%. The main conversion causes include difficulties in esophageal anastomosis, limited exposure and deteriorating the patient’s condition. Anastomotic leak and stenosis were observed in 20% and 40% respectively. Overall mortality rate was 4.2%.Conclusion: Thoracoscopic repair of esophageal atresia seems feasible and safe with considerable superiorities to the conventional method although acceptable results needs a prolonged learning curve and advanced endoscopic surgical skill. Clear judgment about the best surgical intervention for EA according to all cosmetic and functional outcomes needs further studies.

scholarly journals Learning curve for the thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

2017 ◽  
Vol 11 (1) ◽  
pp. 30-34 ◽  
Author(s):  
Hiroomi Okuyama ◽  
Yuko Tazuke ◽  
Takehisa Ueno ◽  
Hiroaki Yamanaka ◽  
Yuichi Takama ◽  
...  
Keyword(s):  
Learning Curve ◽  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Thoracoscopic Repair
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