Minimally invasive repair of esophageal atresia: an update.

We reviewed the available literature on the role of minimally invasive techniques for esophageal atresia (EA)/tracheoesophageal fistula (TEF) repair. No prospective studies have been published to date. According to the recent classification of the Oxford Centre for Evidence based Medicine, the best available evidence for studies comparing the minimally invasive versus open approach for EA/TEF repair is Level 3 (a, b). Similar postoperative results of the thoracoscopic versus conventional repair are confirmed in four retrospective comparative studies and one meta-analysis. However, the available data on complications and postoperative esophageal function are derived from series operated by experienced surgeons in specialized centers. More data on the impact of the learning curve are mandatory before a recommendation on a widespread use can be made. Patient selection and a low threshold for conversion may further improve results.