Dingemann Carmen, Ure Benno M
Department of Pediatric Surgery, Hannover Medical School and Bult Children's Hospital, Hannover, Germany.
Eur J Pediatr Surg. 2013 Jun;23(3):198-203. doi: 10.1055/s-0033-1347914. Epub 2013 May 29.
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.
我们回顾了关于微创技术在食管闭锁（EA）/气管食管瘘（TEF）修复中作用的现有文献。迄今为止尚无前瞻性研究发表。根据牛津循证医学中心的最新分类，比较EA/TEF修复的微创与开放手术方法的研究的最佳现有证据为3级（a，b）。四项回顾性比较研究和一项荟萃分析证实了胸腔镜手术与传统修复术后结果相似。然而，关于并发症和术后食管功能的现有数据来自专业中心经验丰富的外科医生所开展的系列手术。在能够推荐广泛应用之前，必须有更多关于学习曲线影响的数据。患者选择和较低的中转阈值可能会进一步改善结果。
