Kanojia Ravi Prakash, Bhardwaj Neerja, Dwivedi Deepak, Kumar Raj, Joshi Saajan, Samujh Ram, Rao K L N
Department of Pediatric Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
J Indian Assoc Pediatr Surg. 2016 Jul-Sep;21(3):120-4. doi: 10.4103/0971-9261.182585.
To review the technique of thoracoscopic repair of esophageal atresia with tracheoesophageal fistula (TREAT) and results reported in literature and with authors' experience.
The technique of TREAT was reviewed in detail with evaluation in patients treated at authors' institution. The patients were selected based on selection criteria and were followed postoperatively. The results available in literature were also reviewed.
A total of 29 patients (8 females) were operated by TREAT. Mean age was 2.8 days (range 2-6 days). Mean weight was 2.6 kg (range 1.8-3.2 kg). There was a leak in four patients, and two patients had to be diverted. They are now awaiting definitive repair. Twenty-one patients have completed a mean follow-up of 1.5 years and are doing well except for two patients who had a stricture and underwent serial esophageal dilatations. The results from current literature are provided in tabulated form.
TREAT is now a well-established procedure and currently is the preferred approach wherever feasible. The avoidance of thoracotomy is a major advantage to the newborn and is proven to benefit the recovery in the postoperative patient. The technique demonstrated, and the tweaks reported make the procedure easy and is helpful to beginners. The outcome is very much comparable to the open repair as proven by various series. Various parameters like leak rate, anastomotic stricture are the same. The outcome is comparable if you TREAT these babies well.
回顾胸腔镜修补食管闭锁合并气管食管瘘（TREAT）的技术以及文献报道的结果和作者的经验。
详细回顾TREAT技术，并对在作者所在机构接受治疗的患者进行评估。根据选择标准选取患者并进行术后随访。同时也回顾了文献中的可用结果。
共有29例患者（8例女性）接受了TREAT手术。平均年龄为2.8天（范围2 - 6天）。平均体重为2.6千克（范围1.8 - 3.2千克）。4例患者出现渗漏，2例患者不得不进行改道手术。他们目前正在等待最终修复。21例患者完成了平均1.5年的随访，除2例出现狭窄并接受了系列食管扩张术的患者外，其余患者情况良好。以表格形式呈现了当前文献的结果。
TREAT目前是一种成熟的手术方法，在可行的情况下是首选的治疗方式。避免开胸手术对新生儿来说是一个主要优势，并且已证明有利于术后患者的恢复。所展示的技术以及报道的调整方法使该手术变得简单，对初学者有帮助。正如各个系列研究所证明的，其结果与开放修复非常相似。诸如渗漏率、吻合口狭窄等各种参数是相同的。如果对这些婴儿进行良好的治疗，结果是可比的。
