Clinical comparison between thoracoscopic and thoracotomy repair of Gross type C esophageal atresia

Shen Yang, Peize Wang, Zhi Yang, Siqi Li, Junmin Liao, Kaiyun Hua, Yanan Zhang, Yong Zhao, Yichao Gu, Shuangshuang Li, Yongwei Chen, Jinshi Huang, Shen Yang, Peize Wang, Zhi Yang, Siqi Li, Junmin Liao, Kaiyun Hua, Yanan Zhang, Yong Zhao, Yichao Gu, Shuangshuang Li, Yongwei Chen, Jinshi Huang

Abstract

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 two groups according to surgical approaches. The perioperative factors and postoperative complications were compared among the two 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 two 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 two 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.

Keywords: Comparison; Complications; Esophageal atresia; Outcome; Thoracoscopic; Thoracotomy.

Conflict of interest statement

The authors have no conflicts of interest to declare.

© 2021. The Author(s).

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