Rothenberg Steven S
Hospital for Infants and Children at Presbetyrian/St Lukes, Denver, CO, USA.
J Pediatr Surg. 2002 Jun;37(6):869-72. doi: 10.1053/jpsu.2002.32891.
Advancements in minimally invasive surgery in neonates have allowed even the most complex neonatal procedures to be approached using these techniques.
During a period of 15 months, 8 patients born with a proximal esophageal atresia and a distal tracheoesophageal fistula underwent repair thoracoscopically. Weights ranged from 2.1 to 3.4 kg and operating times ranged from 55 to 120 minutes.
All procedures were completed successfully thoracoscopically, and there were no operative complications. One patient had a small leak on day 4 that resolved spontaneously on day 8. All other patients were shown to have a patent anastomosis with no leak by Barium swallow on day 5.
This initial report shows that esophageal repair in the neonate is technically feasible and may provide advantages in terms of exposure and esophageal length, as well as the recognized advantages of avoiding a thoracotomy.
新生儿微创手术的进展使得即使是最复杂的新生儿手术也可采用这些技术进行。
在15个月的时间里,8例患有近端食管闭锁和远端气管食管瘘的新生儿接受了胸腔镜修复手术。体重范围为2.1至3.4千克,手术时间范围为55至120分钟。
所有手术均通过胸腔镜成功完成,且无手术并发症。1例患者在第4天出现小渗漏,于第8天自行缓解。所有其他患者在第5天通过吞钡检查显示吻合口通畅无渗漏。
这份初步报告表明,新生儿食管修复在技术上是可行的,在暴露和食管长度方面可能具有优势,以及避免开胸手术所公认的优势。