Thoracoscopic multistage repair of long-gap esophageal atresia using internal traction
sutures - what time between stages is optimal?
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1
Wroclaw Medical University, Department of Paediatrics, Poland
Introduction: Treatment of long-gap esophageal atresia poses a great challenge for a surgeon. Commonly utilized techniques require multiple surgeries carrying negative complications of open thoracotomy and often do not allow to preserve native esophagus. In our Department a new multistage thoracoscopic technique of long-gap esophageal atresia treatment using internal traction sutures was developed.
Aim: The aim of the study is a retrospective analysis of performed procedures aimed at finding optimal time interval between following surgeries in a multistage treatment.
Methods: 23 cases of newborns with long-gap esophageal atresia (type A and B) were operated thoracoscopically using internal traction sutures between 2008 and 2015 in different hospitals with first author involved personally. Originally time interval between stages was set to be 4 weeks.
Results: Of 23 newborns operated on using internal traction 1 patient died before finishing treatment and was excluded from the analysis. Overall 57 procedures were performed. 13 newborns were operated in two stages, 7 in three stages and 2 in five stages. Time interval between procedures was longer than 4 weeks almost exclusively due to logistical complications and only in two cases because of patient's condition. In two cases time intervals were purposefully shortened to 8 and 15 days. The mean time interval between surgeries was 41,42 days (minimal 8 days and maximal 101 days). For newborns treated in two stages mean time interval was 31,23 days and after exclusion of 2 last patients with aforementioned shortened time interval the mean was 34,81 days. In newborns with esophageal anastomosis performed in third stage mean time interval between 1st and 2nd stage was 51,85 days and between 2nd and 3rd 52,28 days.
Conclusion: Results of the study may indicate that prolonged time interval between procedures does not increase the chance of performing faster esophageal anastomosis.
Keywords:
Thoracoscopic multistage repair,
Long-gap esophageal atresia,
internal traction sutures,
time between stages,
retrospective analysis
Conference:
4th International Conference on Oesophageal Atresia / 15-16 September 2016 / Sydney Australia, Sydney, Australia, 15 Sep - 22 Nov, 2016.
Presentation Type:
Poster
Topic:
Difficult surgical decisions in OA
Citation:
Patkowski
D,
Gerus
S,
Palczewski
M,
Sytnik
J,
Rasiewicz
M,
Zaleska-Dorobisz
U and
Smigiel
R
(2017). Thoracoscopic multistage repair of long-gap esophageal atresia using internal traction
sutures - what time between stages is optimal?.
Front. Pediatr.
Conference Abstract:
4th International Conference on Oesophageal Atresia / 15-16 September 2016 / Sydney Australia.
doi: 10.3389/conf.FPED.2017.01.000017
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Received:
29 Sep 2016;
Published Online:
11 Dec 2017.
*
Correspondence:
Dr. Mateusz Palczewski, Wroclaw Medical University, Department of Paediatrics, Wroclaw, 51-618, Poland, palczewski@przypadkimedyczne.pl
Prof. Robert Smigiel, Wroclaw Medical University, Department of Paediatrics, Wroclaw, 51-618, Poland, robert.smigiel@umw.edu.pl