PDF(Pubmed)
Abstract：
OBJECTIVE: The surgical indication of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula is under debate. The current study aimed to investigate the outcome of thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula in patients weighing < 2000 g and those who underwent emergency surgery at the age of 0 day.
METHODS: The surgical outcomes were compared between patients weighing < 2000 g and those weighing > 2000 g at surgery and between patients who underwent surgery at the age of 0 day and those who underwent surgery at age ≥ 1 day.
RESULTS: In total, 43 patients underwent thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula. The surgical outcomes according to body weight were similar. Patients who underwent surgery at the age of 0 day were more likely to develop anastomotic leakage than those who underwent surgery at the age of ≥ 1 day (2 vs. 0 case, p = 0.02). Anastomotic leakage was treated with conservative therapy.
CONCLUSIONS: Thoracoscopic primary repair is safe and useful for esophageal atresia with tracheoesophageal fistula even in newborns weighing < 2000 g. However, emergency surgery at the age of 0 day should be cautiously performed due to the risk of anastomotic leakage.
METHODS: The surgical outcomes were compared between patients weighing < 2000 g and those weighing > 2000 g at surgery and between patients who underwent surgery at the age of 0 day and those who underwent surgery at age ≥ 1 day.
RESULTS: In total, 43 patients underwent thoracoscopic primary repair for esophageal atresia with tracheoesophageal fistula. The surgical outcomes according to body weight were similar. Patients who underwent surgery at the age of 0 day were more likely to develop anastomotic leakage than those who underwent surgery at the age of ≥ 1 day (2 vs. 0 case, p = 0.02). Anastomotic leakage was treated with conservative therapy.
CONCLUSIONS: Thoracoscopic primary repair is safe and useful for esophageal atresia with tracheoesophageal fistula even in newborns weighing < 2000 g. However, emergency surgery at the age of 0 day should be cautiously performed due to the risk of anastomotic leakage.
摘要：
目的：胸腔镜下一期修补术治疗食管闭锁伴气管食管瘘的手术适应证有争议。本研究旨在调查体重<2000g的患者和在0日龄接受急诊手术的患者在胸腔镜下一期修复食管闭锁伴气管食管瘘的结果。
方法：比较手术时体重<2000g和体重>2000g的患者以及0日龄手术和1日龄手术的患者的手术结果。
结果：总计，43例食管闭锁伴气管食管瘘患者行胸腔镜一期修补术。根据体重的手术结果相似。在0日龄接受手术的患者比在≥1日龄接受手术的患者更容易发生吻合口漏（2与0例,p=0.02)。吻合口漏采用保守治疗。
结论：胸腔镜一期修补术对于伴气管食管瘘的食管闭锁，即使在体重<2000g的新生儿中也是安全有效的。由于存在吻合口漏的风险，应谨慎进行0日龄的急诊手术。
方法：比较手术时体重<2000g和体重>2000g的患者以及0日龄手术和1日龄手术的患者的手术结果。
结果：总计，43例食管闭锁伴气管食管瘘患者行胸腔镜一期修补术。根据体重的手术结果相似。在0日龄接受手术的患者比在≥1日龄接受手术的患者更容易发生吻合口漏（2与0例,p=0.02)。吻合口漏采用保守治疗。
结论：胸腔镜一期修补术对于伴气管食管瘘的食管闭锁，即使在体重<2000g的新生儿中也是安全有效的。由于存在吻合口漏的风险，应谨慎进行0日龄的急诊手术。
