Cano Novillo I, Benavent Gordo M I, García Vázquez A, Antón-Pacheco Sánchez J A, Portela Casalod E, Berchi García F J
Servicio de Cirugía Pediátrica, Hospital Universitario, 12 de Octubre, Madrid.
Cir Pediatr. 2004 Jul;17(3):149-52.
We present the first three cases of esophageal atresia with tracheoesophageal fistula treated with a thoracoscopic approach in our Service. The technique was accomplished through three trocar inserted in the right hemithorax. Carbon dioxide insufflation was required for lung retraction Primary correction was carried out in all the cases without major perioperative complications. The mean surgical time was 240 minutes. One patient had an anastomotic leak, resulting in a complicated postoperative course. The leak healed on conservative treatment. The others two patients were fed at the seventh postoperative day. Mean hospital stay in these cases was 12 days. Although thoracoscopic repair of esophageal atresia with fistula is a currently feasible technique that offers different advantages on the conventional open technique, a greater number of cases is needed in order to advance in the learning curve and determine the exact place that this technique can have in the future treatment of esophageal atresia.
我们展示了在我们科室首例采用胸腔镜方法治疗的三例食管闭锁合并气管食管瘘病例。该技术通过插入右半胸的三个套管针完成。需要二氧化碳气腹来使肺回缩。所有病例均进行了一期矫正,且无重大围手术期并发症。平均手术时间为240分钟。一名患者出现吻合口漏,导致术后病程复杂。经保守治疗后漏口愈合。另外两名患者在术后第7天开始喂养。这些病例的平均住院时间为12天。尽管胸腔镜修复食管闭锁合并瘘是一种目前可行的技术,与传统开放技术相比具有不同优势,但为了在学习曲线方面取得进展并确定该技术在未来食管闭锁治疗中的确切地位,还需要更多病例。