Thoracoscopy Versus Thoracotomy in the Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula
Thoracoscopic repair of esophageal atresia (EA) is gaining popularity, but it is a highly technically demanding procedure. The aim of our study is to evaluate our outcomes in the management of type C EA comparing the thoracoscopic and the open (thoracotomy) approaches. This is a retrospective bicent...
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| Veröffentlicht in: | Journal of laparoendoscopic & advanced surgical techniques. Part A 2020-12, Vol.30 (12), p.1289-1294 |
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| container_title | Journal of laparoendoscopic & advanced surgical techniques. Part A |
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| creator | Elhattab, Ahmad Ali, Liza Rousseau, Veronique Clermidi, Pauline Michelet, Daphné Farnoux, Caroline Lapillonne, Alexandre Aly, Kamal Abdel-Elah Sarnacki, Sabine Bonnard, Arnaud Khen-Dunlop, Naziha |
| description | Thoracoscopic repair of esophageal atresia (EA) is gaining popularity, but it is a highly technically demanding procedure. The aim of our study is to evaluate our outcomes in the management of type C EA comparing the thoracoscopic and the open (thoracotomy) approaches.
This is a retrospective bicentric study of two major pediatric surgery centers, reviewing all the patients operated for EA with distal tracheoesophageal fistula. Only patients who underwent primary anastomosis were included. From 2008 to 2018, 187 patients were included.
Forty-seven patients were operated thoracoscopically (TS group) and 140 by the open approach (TT group). Mean gestational age was 38 ± 2.4 weeks in TS group and 36.4 ± 3.3 weeks in TT group (
= .005) with a mean birth weight of 2785 ± 654 g and 2404.9 ± 651 g in TS and TT groups, respectively (
= .003). The mean operative time was 127.6 ± 35 minutes in TS group and 105.7 ± 23 minutes in TT group (
= .0005). The mean postoperative ventilation time and the mean length of stay were significantly shorter in the thoracoscopic group (
= .004 and
|
| doi_str_mv | 10.1089/lap.2020.0642 |
| format | Article |
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This is a retrospective bicentric study of two major pediatric surgery centers, reviewing all the patients operated for EA with distal tracheoesophageal fistula. Only patients who underwent primary anastomosis were included. From 2008 to 2018, 187 patients were included.
Forty-seven patients were operated thoracoscopically (TS group) and 140 by the open approach (TT group). Mean gestational age was 38 ± 2.4 weeks in TS group and 36.4 ± 3.3 weeks in TT group (
= .005) with a mean birth weight of 2785 ± 654 g and 2404.9 ± 651 g in TS and TT groups, respectively (
= .003). The mean operative time was 127.6 ± 35 minutes in TS group and 105.7 ± 23 minutes in TT group (
= .0005). The mean postoperative ventilation time and the mean length of stay were significantly shorter in the thoracoscopic group (
= .004 and
< .0001, respectively). The incidence of anastomotic leak was 8.9% in TS group versus 16.4% in TT group (
= .33). Anastomotic stenosis occurred in 33.3% of TS group and in 22.4% of TT group (
= .17).
Surgical outcome of thoracoscopic repair of EA is comparable to the open repair with no higher complication rate with the expected skeletal and cosmetic benefits. However, possible bias regarding prematurity, weight at surgery, and associated anomalies must be taken into consideration.</description><identifier>ISSN: 1092-6429</identifier><identifier>EISSN: 1557-9034</identifier><identifier>DOI: 10.1089/lap.2020.0642</identifier><identifier>PMID: 33155851</identifier><language>eng</language><publisher>United States</publisher><subject>Anastomosis, Surgical ; Esophageal Atresia - surgery ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Operative Time ; Postoperative Period ; Retrospective Studies ; Thoracoscopy - methods ; Thoracotomy - methods ; Tracheoesophageal Fistula - surgery ; Treatment Outcome</subject><ispartof>Journal of laparoendoscopic & advanced surgical techniques. Part A, 2020-12, Vol.30 (12), p.1289-1294</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c293t-ce1830c31dc907944ee32705d781369d2c4d0e111c51f47101a3fb4c1c92086d3</citedby><cites>FETCH-LOGICAL-c293t-ce1830c31dc907944ee32705d781369d2c4d0e111c51f47101a3fb4c1c92086d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33155851$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Elhattab, Ahmad</creatorcontrib><creatorcontrib>Ali, Liza</creatorcontrib><creatorcontrib>Rousseau, Veronique</creatorcontrib><creatorcontrib>Clermidi, Pauline</creatorcontrib><creatorcontrib>Michelet, Daphné</creatorcontrib><creatorcontrib>Farnoux, Caroline</creatorcontrib><creatorcontrib>Lapillonne, Alexandre</creatorcontrib><creatorcontrib>Aly, Kamal Abdel-Elah</creatorcontrib><creatorcontrib>Sarnacki, Sabine</creatorcontrib><creatorcontrib>Bonnard, Arnaud</creatorcontrib><creatorcontrib>Khen-Dunlop, Naziha</creatorcontrib><title>Thoracoscopy Versus Thoracotomy in the Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula</title><title>Journal of laparoendoscopic & advanced surgical techniques. Part A</title><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><description>Thoracoscopic repair of esophageal atresia (EA) is gaining popularity, but it is a highly technically demanding procedure. The aim of our study is to evaluate our outcomes in the management of type C EA comparing the thoracoscopic and the open (thoracotomy) approaches.
This is a retrospective bicentric study of two major pediatric surgery centers, reviewing all the patients operated for EA with distal tracheoesophageal fistula. Only patients who underwent primary anastomosis were included. From 2008 to 2018, 187 patients were included.
Forty-seven patients were operated thoracoscopically (TS group) and 140 by the open approach (TT group). Mean gestational age was 38 ± 2.4 weeks in TS group and 36.4 ± 3.3 weeks in TT group (
= .005) with a mean birth weight of 2785 ± 654 g and 2404.9 ± 651 g in TS and TT groups, respectively (
= .003). The mean operative time was 127.6 ± 35 minutes in TS group and 105.7 ± 23 minutes in TT group (
= .0005). The mean postoperative ventilation time and the mean length of stay were significantly shorter in the thoracoscopic group (
= .004 and
< .0001, respectively). The incidence of anastomotic leak was 8.9% in TS group versus 16.4% in TT group (
= .33). Anastomotic stenosis occurred in 33.3% of TS group and in 22.4% of TT group (
= .17).
Surgical outcome of thoracoscopic repair of EA is comparable to the open repair with no higher complication rate with the expected skeletal and cosmetic benefits. However, possible bias regarding prematurity, weight at surgery, and associated anomalies must be taken into consideration.</description><subject>Anastomosis, Surgical</subject><subject>Esophageal Atresia - surgery</subject><subject>Female</subject><subject>Gestational Age</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Operative Time</subject><subject>Postoperative Period</subject><subject>Retrospective Studies</subject><subject>Thoracoscopy - methods</subject><subject>Thoracotomy - methods</subject><subject>Tracheoesophageal Fistula - surgery</subject><subject>Treatment Outcome</subject><issn>1092-6429</issn><issn>1557-9034</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkE1PwzAMhiMEYmNw5Ipy5NLhfHRtjtPYAGkSEhpcqyx1aVC7lKQV2r8nEwN8sfX6sQ8PIdcMpgxyddfobsqBwxRmkp-QMUvTLFEg5GmcQfEkxmpELkL4gFhKyHMyEiJiecrGxG5q57VxwbhuT9_QhyHQY9a7dk_tjvY10hfstPXUVXQZXFfrd9QNnfceg9X0y_Y1vbehj9kmXtbo8J9axcXQ6EtyVukm4NWxT8jrarlZPCbr54enxXydGK5EnxhkuQAjWGkUZEpKRMEzSMssZ2KmSm5kCcgYMymrZMaAaVFtpWFGcchnpZiQ25-_nXefA4a-aG0w2DR6h24IBZdpDiLNQEY0-UGNdyF4rIrO21b7fcGgONgtot3iYLc42I38zfH1sG2x_KN_dYpv0FB19Q</recordid><startdate>202012</startdate><enddate>202012</enddate><creator>Elhattab, Ahmad</creator><creator>Ali, Liza</creator><creator>Rousseau, Veronique</creator><creator>Clermidi, Pauline</creator><creator>Michelet, Daphné</creator><creator>Farnoux, Caroline</creator><creator>Lapillonne, Alexandre</creator><creator>Aly, Kamal Abdel-Elah</creator><creator>Sarnacki, Sabine</creator><creator>Bonnard, Arnaud</creator><creator>Khen-Dunlop, Naziha</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202012</creationdate><title>Thoracoscopy Versus Thoracotomy in the Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula</title><author>Elhattab, Ahmad ; Ali, Liza ; Rousseau, Veronique ; Clermidi, Pauline ; Michelet, Daphné ; Farnoux, Caroline ; Lapillonne, Alexandre ; Aly, Kamal Abdel-Elah ; Sarnacki, Sabine ; Bonnard, Arnaud ; Khen-Dunlop, Naziha</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c293t-ce1830c31dc907944ee32705d781369d2c4d0e111c51f47101a3fb4c1c92086d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Anastomosis, Surgical</topic><topic>Esophageal Atresia - surgery</topic><topic>Female</topic><topic>Gestational Age</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Operative Time</topic><topic>Postoperative Period</topic><topic>Retrospective Studies</topic><topic>Thoracoscopy - methods</topic><topic>Thoracotomy - methods</topic><topic>Tracheoesophageal Fistula - surgery</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elhattab, Ahmad</creatorcontrib><creatorcontrib>Ali, Liza</creatorcontrib><creatorcontrib>Rousseau, Veronique</creatorcontrib><creatorcontrib>Clermidi, Pauline</creatorcontrib><creatorcontrib>Michelet, Daphné</creatorcontrib><creatorcontrib>Farnoux, Caroline</creatorcontrib><creatorcontrib>Lapillonne, Alexandre</creatorcontrib><creatorcontrib>Aly, Kamal Abdel-Elah</creatorcontrib><creatorcontrib>Sarnacki, Sabine</creatorcontrib><creatorcontrib>Bonnard, Arnaud</creatorcontrib><creatorcontrib>Khen-Dunlop, Naziha</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elhattab, Ahmad</au><au>Ali, Liza</au><au>Rousseau, Veronique</au><au>Clermidi, Pauline</au><au>Michelet, Daphné</au><au>Farnoux, Caroline</au><au>Lapillonne, Alexandre</au><au>Aly, Kamal Abdel-Elah</au><au>Sarnacki, Sabine</au><au>Bonnard, Arnaud</au><au>Khen-Dunlop, Naziha</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Thoracoscopy Versus Thoracotomy in the Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula</atitle><jtitle>Journal of laparoendoscopic & advanced surgical techniques. Part A</jtitle><addtitle>J Laparoendosc Adv Surg Tech A</addtitle><date>2020-12</date><risdate>2020</risdate><volume>30</volume><issue>12</issue><spage>1289</spage><epage>1294</epage><pages>1289-1294</pages><issn>1092-6429</issn><eissn>1557-9034</eissn><abstract>Thoracoscopic repair of esophageal atresia (EA) is gaining popularity, but it is a highly technically demanding procedure. The aim of our study is to evaluate our outcomes in the management of type C EA comparing the thoracoscopic and the open (thoracotomy) approaches.
This is a retrospective bicentric study of two major pediatric surgery centers, reviewing all the patients operated for EA with distal tracheoesophageal fistula. Only patients who underwent primary anastomosis were included. From 2008 to 2018, 187 patients were included.
Forty-seven patients were operated thoracoscopically (TS group) and 140 by the open approach (TT group). Mean gestational age was 38 ± 2.4 weeks in TS group and 36.4 ± 3.3 weeks in TT group (
= .005) with a mean birth weight of 2785 ± 654 g and 2404.9 ± 651 g in TS and TT groups, respectively (
= .003). The mean operative time was 127.6 ± 35 minutes in TS group and 105.7 ± 23 minutes in TT group (
= .0005). The mean postoperative ventilation time and the mean length of stay were significantly shorter in the thoracoscopic group (
= .004 and
< .0001, respectively). The incidence of anastomotic leak was 8.9% in TS group versus 16.4% in TT group (
= .33). Anastomotic stenosis occurred in 33.3% of TS group and in 22.4% of TT group (
= .17).
Surgical outcome of thoracoscopic repair of EA is comparable to the open repair with no higher complication rate with the expected skeletal and cosmetic benefits. However, possible bias regarding prematurity, weight at surgery, and associated anomalies must be taken into consideration.</abstract><cop>United States</cop><pmid>33155851</pmid><doi>10.1089/lap.2020.0642</doi><tpages>6</tpages></addata></record> |
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| subjects | Anastomosis, Surgical Esophageal Atresia - surgery Female Gestational Age Humans Infant, Newborn Male Operative Time Postoperative Period Retrospective Studies Thoracoscopy - methods Thoracotomy - methods Tracheoesophageal Fistula - surgery Treatment Outcome |
| title | Thoracoscopy Versus Thoracotomy in the Repair of Esophageal Atresia with Distal Tracheoesophageal Fistula |
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