Department of Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
Asian J Endosc Surg. 2021 Apr;14(2):301-304. doi: 10.1111/ases.12862. Epub 2020 Sep 3.
Right aortic arch (RAA) is one of congenital cardiovascular anomalies associated with esophageal atresia (EA). The surgical treatment for EA with RAA is still challenging. Although most pediatric surgeons are familiar with the right-sided approach, the division of the tracheoesophageal fistula and the anastomosis of the esophagus through right thorax are often difficult in cases of RAA. There are a few reports on thoracoscopic repair for EA with RAA. We report a case of EA with RAA treated by left-sided thoracoscopic approach. With left-sided thoracoscopic approach, identification and anastomosis of the esophagus could be safely performed without obstruction by the right-sided descending aorta. There was no leakage or stricture. Thoracoscopic repair of EA with RAA through the left thorax is feasible and safe without obstruction by the right-sided descending aorta.
右位主动脉弓(RAA)是一种与食管闭锁(EA)相关的先天性心血管异常。对于 RAA 合并 EA 的手术治疗仍然具有挑战性。尽管大多数小儿外科医生都熟悉右侧入路,但在 RAA 病例中,通过右侧胸腔分离气管食管瘘并进行食管吻合通常较为困难。目前已有少数关于 RAA 合并 EA 经胸腔镜修复的报道。我们报告了一例 RAA 合并 EA 经左侧胸腔镜入路治疗的病例。通过左侧胸腔镜入路,可以安全地识别和吻合食管,而不会受到右侧降主动脉的阻碍。没有出现渗漏或狭窄。左侧胸腔镜下 RAA 合并 EA 的修复是可行且安全的,不会受到右侧降主动脉的阻碍。