Thoracoscopic versus conventional open repair of tracheoesophageal fistula in neonates: A short-term comparative study

Rozeik, Ahmed Ezzat; Elbarbary, Mohamed M.; Saleh, Amin Mohamed; Khodary, Ahmed Refaat; Alekrashy, Mohammad Ahmad

doi:10.1016/j.jpedsurg.2019.09.040

Cited by 24 publications

(8 citation statements)

References 29 publications

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“…Only one study mentioned that there are no significant differences in the HRQOL of children after school age between the traditional and thoracoscopic surgery groups ( 29 ). Our findings support that thoracoscopic repair has the advantages of less trauma and superior cosmetic results compared with the thoracotomy ( 30 ), which could improve body perception.…”

Section: Discussionsupporting

confidence: 83%

Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China

Feng,

Zhu,

et al. 2024

Front. Pediatr.

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ObjectiveTo investigate health-related quality of life (HRQOL) in patients after surgical repair for esophageal atresia (EA) and identify its potential influencing factors.MethodsA total of 102 EA children who had previously visited our hospital participated in this cross-sectional study. Basic data and disease data of the patients were collected. The HRQOL was measured with the Pediatric Quality of Life Inventory™4.0 (PedsQL™4.0) and EA-QOL questionnaire and ranked on a reverse 0–100 scale, with a higher number indicative of a better HRQOL perception. The scores of PedsQL™4.0 in children with EA were collected and compared with that of the demographically matched healthy control group. Meanwhile, the condition-specific HRQOL of EA was analyzed by the EA-QOL questionnaire, and the potential clinical factors that influenced the HRQOL were determined by the generalized linear model.ResultsThe group of EA and control reached a similar score in the generic PedsQL™4.0 (EA group: 86.55 ± 9.69; control group: 89.41 ± 6.54; p = 0.670). There was no significant difference between the EA group and the control group in other domains except the school functioning. Condition-specific HRQOL in the 2–7-year-old group had the highest score in social isolation and stress domain and the lowest score in the physical health and treatment domain, with an overall quality of life score of 83.48 ± 10.22. The scores of the 8–17-year-old group were relatively high in social relationships and health and well-being and lowest in the eating domain, with an overall quality of life score of 89.43 ± 8.57. Heart malformation, complicated esophageal surgery history, respiratory symptoms,and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 2–7 years. Complicated esophageal surgery history, respiratory symptoms, and digestive symptoms in the past 1 month were the main factors affecting the HRQOL of children aged 8–17 years.ConclusionsThe findings suggest that patients with EA generally had a good HRQOL. However, EA children with postoperative complications and associated symptoms have lower scores in the EA-QOL questionnaire.

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Section: Discussionsupporting

confidence: 83%

Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China

Feng,

Zhu,

et al. 2024

Front. Pediatr.

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“…The reported rate of conversion from thoracoscopy to thoracotomy surgery in literature ranges from 4-44% [10]. In the present study, 6 patients (9.68%) were converted to thoracotomy surgery due to decreased oxygen saturation or high esophageal anastomosis tension.…”

Section: Discussionmentioning

confidence: 51%

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

Yang

Wang

Yang

et al. 2021

Preprint

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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.

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“…Alternatives are open or endoscopic treatment. The disadvantages of thoracotomy are already widely described when discussing esophageal atresia, and they include longer time to extubation and first oral feeding, longer postoperative stay, and higher risk of chest deformities [13,19,20]. Authors of the biggest series of open RTEF repair do not provide operative times or postoperative hospital stays [2][3][4]7,8].…”

Section: Discussionmentioning

confidence: 99%

Novel Left-Sided Thoracoscopic Approach to Recurrent Tracheoesophageal Fistula and Post-Fistula Tracheal Diverticula

Patkowski,

Toczewski,

Ergun

2023

JCM

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Background: Recurrent tracheoesophageal fistula (RTEF) is usually a consequence of leakage or other complications after esophageal atresia repair performed through right-sided access. This results in extensive intrapleural adhesions, and open redo surgery poses a challenge. Alternatively, endoscopic endotracheal fistula obliteration usually requires repetitive procedures, and its success rate varies significantly between centers. We present a novel approach to recurrent fistulas. The innovation is in reaching the fistula through the virgin field via left-sided three-port thoracoscopy instead of classical right-sided thoracotomy. Methods: This is a presentation of a new operative technique based on a retrospective case series of patients operated on at our department between 2016 and 2023. Results: Eight patients after esophageal atresia repair (six with RTEF and two with post-fistula tracheal diverticula) were successfully treated with left-sided thoracoscopy. There were no conversions. One patient required rethoracoscopy for chylothorax. Another one, after RTEF closure, underwent multiple endoscopic obliterations of subsequent tracheal diverticulum. No other major complications nor re-recurrences were noted. Conclusions: Left-sided thoracoscopy in redo esophageal atresia has the advantage of a “virgin” operative field and grants feasible access to the RTEF or tracheal diverticulum. We believe that this approach is worth further exploration because it combines minimal invasiveness with high effectiveness without all the consequences of a thoracotomy.

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Thoracoscopic versus conventional open repair of tracheoesophageal fistula in neonates: A short-term comparative study

Cited by 24 publications

References 29 publications

Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China

Health-related quality of life in children after surgical repair of esophageal atresia: a cross-sectional study in China

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

Novel Left-Sided Thoracoscopic Approach to Recurrent Tracheoesophageal Fistula and Post-Fistula Tracheal Diverticula

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