Congenital esophageal atresia treated with thoracoscopic approach – results of surgical treatment

Abstract

Introduction: The first thoracoscopic esophageal atresia (EA) surgery in Poland was performed by Professor Dariusz Patkowski in 2005 in Wrocław. In the Clinical Ward of Pediatric Surgery and Urology, Regional Specialistic Children’s Hospital in Olsztyn, thoracoscopic EA surgery was performed on 16 January 2009. Aim: Data presentation on thoracoscopic treatment of congenital EA. Material and methods: Between 2009 and 2018 in our Clinical Ward, 28 children (11 females and 17 males) diagnosed with EA underwent treatment. All patients presented with type III EA based on the Gross classification (lower tracheoesophageal fistula and atresia of the upper segment of the trachea) and 8 of them (29.6%) were diagnosed with coexisting diseases. Results and discussion: The duration of the surgery was 70–290 minutes with a mean time of 180 minutes. Conversion was performed in 6 (21.4%) cases. Leakage of the lymph occurred in 2 (7.1%) cases . In 3 (10.7%) cases, a radiographic image showed leakage of the anastomosis. Only 1 (3.6%) patient needed reoperation due to re-canalization of tracheoesophageal fistula. Pneumothorax occurred in 2 (7.1%) cases. In total, 4 (14.3%) patients died and 23 (82.1%) patients required additional esophageal dilatation due to its narrowing. Conclusions: The treatment results of thoracoscopic EA surgeries and undeniable advantages for the patient makes this technique a highly recommended method.