Update on Thoracoscopic Repair of Esophageal Atresia with and without Tracheoesophageal Fistula

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Abstract
Background: Repair of esophageal atresia (EA) with or without tracheoesophageal fistula (TEF) is a major operation for newborn infants, who often are premature and small for gestational age. In an effort to minimize perioperative stress, recent technologic advances have been applied that permit certain traditional open operations to be performed using minimally invasive techniques. This article provides an update on our experience with endosurgical techniques to repair various types of EA. Patients and Methods: The records of 10 neonatal infants having thoracoscopy to repair EA either with and without TEF were reviewed. Outcome measures included operative time, intraoperative complications, leak, empyema, and stricture formation. Results: Nine of the procedures were completed using thoracoscopy, and no intraoperative complications were encountered. Two babies had mild salivary leaks that resolved spontaneously within 48 hours of onset. Three patients required bougienage for relief of mild strictures. All babies are alive and thriving on oral feeding. Conclusion: Thoracoscopic repair of EA with or without TEF not only is technically feasible but provides a safe alternative to classic open thoracotomy that is as successful and less physiologically stressful.