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

Am J Surg. 2011 Aug;202(2):203-6. 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.

Publication types

  • Comparative Study

MeSH terms

  • Abnormalities, Multiple
  • Esophageal Atresia / complications
  • Esophageal Atresia / surgery*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Thoracoscopy*
  • Thoracotomy*
  • Tracheoesophageal Fistula / complications
  • Tracheoesophageal Fistula / congenital
  • Tracheoesophageal Fistula / surgery*
  • Treatment Outcome