van der Zee David C, Gallo Gabriele, Tytgat Stefaan H A
Department of Pediatric Surgery KE.04.140.5, Wilhelmina Children's Hospital, University Medical Center Utrecht, P.O. Box 85090, 3508 AB, Utrecht, The Netherlands.
Department of Pediatric Surgery, University Medical Center, Groningen, The Netherlands.
Surg Endosc. 2015 Nov;29(11):3324-30. doi: 10.1007/s00464-015-4091-3. Epub 2015 Feb 11.
To describe the evolution from delayed management of long gap esophageal atresia to thoracoscopic treatment directly after birth without the placement of a gastrostomy.
Long gap esophageal atresia remains a challenge for pediatric surgeons. Over the years, several techniques have been described to deal with the problem of the distance between the proximal and distal esophagus. More recently, a traction technique has been advocated. With the advent of minimal invasive surgery, the thoracoscopic elongation technique has been developed.
Retrospective description of a single-center experience with the thoracoscopic treatment of patients with long gap esophageal atresia over a 7-year period.
Between 2007 and May 2014, 10 children with long gap esophageal atresia were treated by thoracoscopic elongation technique. In two children, the procedure failed. Eight children successfully underwent thoracoscopic traction with delayed primary anastomosis. Initially, all patients had a gastrostomy. During the course, the technique evolved into delayed primary anastomosis directly after birth without the use of a gastrostomy.
Thoracoscopic elongation technique in long gap esophageal atresia not only is feasible, but can nowadays also be performed directly after birth without the use of a gastrostomy. With this development, we have entered a new era in the management of long gap esophageal atresia.
描述从长段食管闭锁的延迟处理到出生后直接进行胸腔镜治疗且不放置胃造口术的演变过程。
长段食管闭锁对小儿外科医生来说仍然是一项挑战。多年来，已经描述了几种技术来处理食管近端和远端之间距离的问题。最近，一种牵引技术被提倡。随着微创手术的出现，胸腔镜延长技术得以发展。
回顾性描述单中心在7年期间对长段食管闭锁患者进行胸腔镜治疗的经验。
2007年至2014年5月，10例长段食管闭锁患儿接受了胸腔镜延长技术治疗。2例患儿手术失败。8例患儿成功接受胸腔镜牵引并延迟一期吻合。最初，所有患者均有胃造口术。在此过程中，该技术演变为出生后直接进行延迟一期吻合且不使用胃造口术。
长段食管闭锁的胸腔镜延长技术不仅可行，而且现在可以在出生后直接进行且不使用胃造口术。随着这一进展，我们在长段食管闭锁的治疗方面进入了一个新时代。
