Thoracoscopic repair of congenital isolated H-type tracheoesophageal fistula.
Bronchoscopy
Congenital anomalies
Esophageal atresia
Thoracoscopy
Tracheoesophageal fistula
Journal
Journal of pediatric surgery
ISSN: 1531-5037
Titre abrégé: J Pediatr Surg
Pays: United States
ID NLM: 0052631
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
received:
02
07
2020
revised:
28
07
2020
accepted:
19
08
2020
pubmed:
26
9
2020
medline:
18
8
2021
entrez:
25
9
2020
Statut:
ppublish
Résumé
The available literature on congenital isolated H-type tracheoesophageal fistula (TEF) is limited, and preferred approach varies among centers (cervicotomy, thoracotomy, thoracoscopy). We aimed to present one of the biggest case series of thoracoscopic approach for congenital isolated TEF and to assess the method's feasibility and outcomes. Retrospective review of thoracoscopic TEF repair experiences at 2 European university pediatric surgery centers. 9 boys and 3 girls were involved in the study (age 5 days-4 years), 8 of them were newborns (mean birth weight 3013 g, mean gestational age 39 weeks). The most common presenting symptoms were desaturations on feeding in neonates and recurrent respiratory tract infections in older children. The diagnoses were established on contrast study and confirmed with rigid bronchoscopy. The fistulas were located at or below the thoracic inlet; the fistulas were 2 cm above the carina to half the height of the trachea. All patients underwent successful thoracoscopic TEF repair. There were no conversions. The postoperative course was uneventful in all but one who had rethoracoscopy for prolonged postoperative chylothorax. All patients had satisfactory vocal cord function. One patient required reoperation for fistula recurrence 8 months after primary surgery. Thoracoscopic approach for isolated H-type TEF seems to be possible as a procedure of choice with satisfactory results and all benefits of minimally invasive procedure. IV (case series).
Sections du résumé
BACKGROUND/PURPOSE
OBJECTIVE
The available literature on congenital isolated H-type tracheoesophageal fistula (TEF) is limited, and preferred approach varies among centers (cervicotomy, thoracotomy, thoracoscopy). We aimed to present one of the biggest case series of thoracoscopic approach for congenital isolated TEF and to assess the method's feasibility and outcomes.
METHODS
METHODS
Retrospective review of thoracoscopic TEF repair experiences at 2 European university pediatric surgery centers.
RESULTS
RESULTS
9 boys and 3 girls were involved in the study (age 5 days-4 years), 8 of them were newborns (mean birth weight 3013 g, mean gestational age 39 weeks). The most common presenting symptoms were desaturations on feeding in neonates and recurrent respiratory tract infections in older children. The diagnoses were established on contrast study and confirmed with rigid bronchoscopy. The fistulas were located at or below the thoracic inlet; the fistulas were 2 cm above the carina to half the height of the trachea. All patients underwent successful thoracoscopic TEF repair. There were no conversions. The postoperative course was uneventful in all but one who had rethoracoscopy for prolonged postoperative chylothorax. All patients had satisfactory vocal cord function. One patient required reoperation for fistula recurrence 8 months after primary surgery.
CONCLUSION
CONCLUSIONS
Thoracoscopic approach for isolated H-type TEF seems to be possible as a procedure of choice with satisfactory results and all benefits of minimally invasive procedure.
LEVEL OF EVIDENCE
METHODS
IV (case series).
Identifiants
pubmed: 32972739
pii: S0022-3468(20)30608-4
doi: 10.1016/j.jpedsurg.2020.08.024
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1386-1388Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.