Repair of esophageal atresia with tracheoesophageal fistula via thoracotomy: a contemporary series

• Published in: The American journal of surgery Vol. 202; no. 2; pp. 203 - 206
• Main Authors: Burford, Jeffrey M., M.D, Dassinger, Melvin S., M.D, Copeland, Daniel R., M.D, Keller, Jennifer E., M.D, Smith, Samuel D., M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-08-2011; Elsevier; Elsevier Limited
• Subjects: Abnormalities, Multiple; Anomalies; Biological and medical sciences; Children; Complications; Defects; Demographics; Demography; Down syndrome; Esophageal atresia; Esophageal Atresia - complications; Esophageal Atresia - surgery; Esophagus; Female; Fistulae; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Humans; Infant; Infant, Newborn; Intervention; Male; Malformations; Medical sciences; Mortality; Newborn babies; Ostomy; Patients; Pneumology; Repair; Respiratory system : syndromes and miscellaneous diseases; Retrospective Studies; Scoliosis; Stricture; Studies; Surgery; Surgical outcomes; Thoracoscopic surgery; Thoracoscopy; Thoracotomy; Tracheoesophageal fistula; Tracheoesophageal Fistula - complications; Tracheoesophageal Fistula - congenital; Tracheoesophageal Fistula - surgery; Treatment Outcome; Vertebrae; Esophageal atresia; Thoracotomy; Tracheoesophageal fistula; Thoracoscopic surgery; Endoscopic surgery; Diseases of the trachea; Respiratory disease; Esophageal disease; Medicine; Treatment; Digestive diseases; Endoscopy; Repair; Thoracoscopy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2010.09.035

Abstract Background A recent series detailing thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (EA/TEF) reported lower complication rates compared with historic controls. This study provides a contemporary cohort of patients repaired via thoracotomy for comparison with the recent large multi-institutional thoracoscopic series. Methods Records of patients with EA/TEF between 1993 and 2008 were reviewed. Attention was focused on demographics and complications including anastomotic leak, recurrent fistulae, stricture formation, and need for fundoplication. Results Seventy-two patients underwent repair of EA/TEF via thoracotomy. Complication rates in the current series compared with the thoracoscopic series were anastomotic leak, 2.7% versus 7.6%; recurrent fistulae, 2.7% versus 1.9%; stricture, 5.5% versus 3.8%; and need for fundoplication, 12% versus 24%. Differences in complication rates did not reach statistical significance. Two children in this cohort developed mild scoliosis attributed to congenital vertebral anomalies, neither of whom required intervention. Conclusions Thoracoscopic repair of EA/TEF yielded complication rates similar to this contemporary series; however, trends toward increased anastomotic leaks and greater need for fundoplication were noted. No musculoskeletal sequelae were directly attributable to thoracotomy.