Thoracoscopic Esophageal Atresia with Tracheoesophageal Fistula Repair: The First Iranian Group Report, Passing the Learning Curve

Authors

  • Mehran Hiradfar Mashhad University of Medical Sciences, Mashhad, Iran
  • Mohammad Gharavifard Mashhad University of Medical Sciences, Mashhad, Iran
  • Reza Shojaeian Mashhad University of Medical Sciences, Mashhad, Iran
  • Marjan Joodi Mashhad University of Medical Sciences, Mashhad, Iran
  • Reza Nazarzadeh Mashhad University of Medical Sciences, Mashhad, Iran
  • Alireza Sabzevari Mashhad University of Medical Sciences, Mashhad, Iran
  • Nazila Yal Mashhad University of Medical Sciences, Mashhad, Iran
  • Reza Eslami Mashhad University of Medical Sciences, Mashhad, Iran
  • Ahmad Mohammadipour Mashhad University of Medical Sciences, Mashhad, Iran
  • Ali Azadmand Mashhad University of Medical Sciences, Mashhad, Iran

DOI:

https://doi.org/10.21699/jns.v5i3.344

Keywords:

Esophageal atresia, Tracheoesophageal fistula, Thoracoscopy, Neonate, Minimally invasive

Abstract

Background: Thoracoscopic treatment of esophageal atresia and tracheoesophageal fistula (EA+TEF) is accepted as a superior technique at least in cosmetic point of view but it is considered as an advance endoscopic procedure that needs a learning curve to be performed perfectly. This is the first report of Iranian group pediatric surgeons in thoracoscopic approach to EA.

Methods & Materials: Since 2010, twenty four cases with EA+TEF underwent thoracoscopic approach in Sarvar children Hospital (Mashhad -Iran). During the first 6 months, thoracoscopic approach to 6 cases of EA+TEF was converted to open procedure because of technical and instrumental problems. The first case of successful thoracoscopic EA repair was accomplished in 2010 and since then, 10 cases of EA+ TEF among 18 patients were treated successfully with thoracoscopic approach

Results: Overall conversion rate was 58.3% but conversion rate after the primary learning curve period, was 35.7%. The main conversion causes include difficulties in esophageal anastomosis, limited exposure and deteriorating the patient’s condition. Anastomotic leak and stenosis were observed in 20% and 40% respectively. Overall mortality rate was 4.2%.

Conclusion: Thoracoscopic repair of esophageal atresia seems feasible and safe with considerable superiorities to the conventional method although acceptable results needs a prolonged learning curve and advanced endoscopic surgical skill. Clear judgment about the best surgical intervention for EA according to all cosmetic and functional outcomes needs further studies.

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Author Biographies

Mehran Hiradfar, Mashhad University of Medical Sciences, Mashhad, Iran

Associate professor of pediatric surgery. Department of pediatric surgery, School of Medicine,Mashhad University of Medical Sciences, Mashhad, Iran

Mohammad Gharavifard, Mashhad University of Medical Sciences, Mashhad, Iran

Associate professor of pediatric anesthesiology. Department of pediatric anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Reza Shojaeian, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant Professor of pediatric surgery

Head of department of pediatric surgery

Sarvar Children's hospital

Mashhad University Of Medical Sciences

Marjan Joodi, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric surgery. Department of pediatric surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Reza Nazarzadeh, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric surgery. Department of pediatric surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Alireza Sabzevari, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric anesthesiology. Department of pediatric anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Nazila Yal, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric anesthesiology. Department of pediatric anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Reza Eslami, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric anesthesiology. Department of pediatric anesthesiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Ahmad Mohammadipour, Mashhad University of Medical Sciences, Mashhad, Iran

Assistant professor of pediatric surgery. Department of pediatric surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

Ali Azadmand, Mashhad University of Medical Sciences, Mashhad, Iran

Resident of pediatric surgery. Department of pediatric surgery, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

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Published

2016-07-01

How to Cite

1.
Hiradfar M, Gharavifard M, Shojaeian R, Joodi M, Nazarzadeh R, Sabzevari A, Yal N, Eslami R, Mohammadipour A, Azadmand A. Thoracoscopic Esophageal Atresia with Tracheoesophageal Fistula Repair: The First Iranian Group Report, Passing the Learning Curve. J Neonatal Surg [Internet]. 2016Jul.1 [cited 2021Feb.28];5(3):29. Available from: https://jneonatalsurg.com/ojs/index.php/jns/article/view/296