NDLI: Thoracoscopic repair of tracheoesophageal fistula and esophageal atresia.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Patkowsk, Dariusz Rysiakiewicz, Konrad Jaworski, Wojciech Zielinska, Marzena Siejka, Grazyna Konsur, Katarzyna Czernik, Jerzy
Description	Country affiliation: Poland Author Affiliation: Patkowsk D ( Department of Paediatric Surgery and Urology, Medical University of Wroclaw,Wroclaw, Poland. dpat@chdz.am.wroc.pl)
Abstract	PURPOSE: To evaluate the safety and efficacy of the thoracoscopic repair of esophageal atresia and tracheoesophageal fistula (EA/TEF). METHODS: From August 2005 to March 2008, 23 consecutive patients (16 boys, 7 girls) weighing 1,070 to 3,390 g underwent thoracoscopic EA/TEF repair. Nine cases had associated malformations. Two 5-mm and one 2.5-mm trocars were placed. The 5-mm 25- to 30-degree telescope was preferred. A pneumothorax was maintained with 5 to 6 mm Hg. The azygos vein was never divided. The TEF was closed with 5-mm titanic clips mainly.The esophageal anastomosis was made over 6-French nasogastric tube by three to seven simple stitches of 5-0Vicryl. The 8-French chest tube was left without suction. The enteral feeding was usually started on postoperative day 3 or 4. Barium swallow was performed on postoperative day 5 or 6, then the chest tube was removed. RESULTS: All procedures were successfully completed without conversion. The average operative time was 131 minutes (range, 55-245 minutes) with significant improvement after gaining experience (mean, 171 minutes for first 10 cases and 98 minutes for last 13 cases). There were two cases of accidental tracheal opening. The anastomotic leak rate was 13% (three cases), and all were healed on conservative treatment. Four cases required one to three courses of anastomotic stricture dilatations. There were three deaths (13%) of causes not related with performed operation. CONCLUSIONS: The thoracoscopic repair of EA/TEF is effective method, and based on our experience, it is the procedure of choice if performed by an experienced endoscopic pediatric surgeon. The intraoperative complications observed if properly managed have a good prognosis.
File Format	HTM / HTML
ISSN	10926429
Issue Number	Suppl 1
Volume Number	19
e-ISSN	15579034
Journal	Journal of Laparoendoscopic & Advanced Surgical Techniques
Language	English
Publisher	Mary Ann Liebert, Inc.
Publisher Date	2009-04-01
Publisher Place	United States
Access Restriction	Subscribed
Subject Keyword	Discipline General Surgery Esophageal Atresia Surgery Thoracoscopy Methods Tracheoesophageal Fistula Female Humans Infant, Newborn Intraoperative Complications Male Journal Article
Content Type	Text
Resource Type	Article
Subject	Surgery

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