Delayed thoracoscopic repair helps preserve native oesophagus in long-gap oesophageal atresia.
Thoracoscopic delayed repair linked to higher native oesophageal preservation in long-gap atresia
Delayed thoracoscopic repair helps preserve native oesophagus in long-gap oesophageal atresia.
Preservation of the native oesophagus is generally considered the preferred strategy for long-gap oesophageal atresia (long-gap oesophageal atresia).
This study aimed to assess whether delayed thoracoscopic repair of long-gap oesophageal atresia was associated to increase rate of oesophageal preservation.
Undergoing delayed anastomotic attempt were grouped according to operative approach (open or thoracoscopic).
thoracoscopic approach far more likely to achieve oesophageal preservation than open
Oesophageal preservation was significantly higher in the thoracoscopic group (88% vs 35%; p = 0.0004).
ICU length of stay, complications, and leak rate did not differ significantly between groups.
Thoracoscopic repair was associated with significantly higher rates of stricture (88% vs 55%; p = 0.018) and increased dilatation requirements (median 3.0 vs 2.0 procedures; p = 0.044).
Kaplan-Meier analysis showed no significant difference in time to achieve exclusive oral feeding (log-rank p = 0.549).
Thoracoscopic delayed repair of long-gap oesophageal atresia was associated with higher rates of native oesophageal preservation, without increased ICU stay or complication rate.
This benefit occurs at the cost of increased anastomotic stricture, although feeding outcomes at 36 months were comparable between groups.