Esophageal atresia (EA) and tracheoesophageal fistula (TEF) is one of the most common congenital malformations of the esophagus, with an incidence of 1/2500–1/4500.
Recent study findings suggest that thoracoscopy surgery is safe and effective surgical option for patients with Gross type C Esophageal atresia (EA) and tracheoesophageal fistula (TEF). The study findings were published in the journal BMC Surgery on November 22, 2021.
Several studies suggest the superiority of thoracoscopic EA/TEF. However, the procedure is technically demanding due to the restricted working space of the neonatal thorax combined with inherent difficulties of using thoracoscopic instruments to perform an esophageal anastomosis under tension and therefore has not been replaced thoracotomy. Recently, researchers of the Beijing Children's Hospital, Beijing, China conducted a study to compare the clinical outcomes between thoracoscopic approach and thoracotomy surgery in patients with Gross type C EA/TEF.
In this retrospective study, the researchers included a total of 190 patients with Gross type C EA/TEF who underwent surgery. They divided the patients into two groups depending on the surgical approach [thoracoscopic (n = 62) and thoracotomy (n = 128) ] and compared the perioperative factors and postoperative complications between the two groups.
Key findings of the study:
On comparing clinical characteristics between the two groups, the researchers found significant differences in associated anomalies, method of fistula closure, duration of mechanical ventilation after surgery, feeding option before discharge, management of pneumothorax, and prognosis favouring thoracoscopy.
They noted that to a certain extent, thoracoscopic surgery reduced the incidence of anastomotic leakage and increased the incidence of anastomotic stricture in this study.
However, they found no statistically significant differences between the two groups in terms of operative time, postoperative pneumothorax, anastomotic leakage, anastomotic stricture, and recurrent tracheoesophageal fistula.
The authors concluded, "The findings of this study show that thoracoscopy surgery of Gross type C EA/TEF is a safe and effective, minimally invasive technique with comparable outcomes and operative time. For experienced surgeons, thoracoscopy can serve as a first-line technique for EA/TEF repair."
For further information
DOI: https://doi.org/10.1186/s12893-021-01360-7