Short-interval staged thoracoscopic surgery for long-gap esophageal atresia

Abstract

Long-gap esophageal atresia is defined by the impossibility to perform a primary anastomosis after birth. We propose a progressive traction surgery by thoracoscopy performed at intervals of 5–7 days. We describe the traction technique of the esophageal pouches through the thoracoscopic approach and without performing a gastrostomy. We use sliding sutures and clips to prevent esophageal tearing and preservation of the azygos vein. In a series of three patients, we have being able to reconstruct the esophagus in a period of 1–3 weeks after birth without complications. Repetitive thoracoscopy at shorts intervals in the neonatal period allows a tension-free anastomosis of the esophagus in long-gap type esophageal atresia.