Department of Pediatric Surgery, Research Field in Medical and Health Sciences, Medical and Dental Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
Department of Pediatric Surgery, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Asian J Endosc Surg. 2022 Jan;15(1):240-243. doi: 10.1111/ases.12947. Epub 2021 May 2.
Long-gap esophageal atresia (EA) remains a challenging operative procedure. Several techniques have been reported to resolve the problem of distance between the proximal and distal esophagus. We report a thoracoscopic intraoperative esophageal close technique for long-gap EA. A female neonate was born at 39 weeks of gestation with long-gap EA (five vertebrae). The patient underwent thoracoscopic esophageal anastomosis after esophageal elongation. Careful dissection of the proximal and distal esophagus was performed; however, the distance between them was still long. Extra-thoracic traction sutures were placed at the upper esophagus. Then, a Neraton catheter was inserted trans-orally and the upper esophagus was pushed and opened. An internal traction suture was placed between the Neraton catheter and lower esophagus. The gap between the proximal and distal esophagus could be approximated by pulling the Neraton catheter. Esophageal anastomosis was performed successfully. Our thoracoscopic intraoperative esophageal close technique was simple and useful.
长段食管闭锁（EA）仍然是一项具有挑战性的手术操作。已经报道了几种技术来解决近端和远端食管之间的距离问题。我们报告了一种用于长段 EA 的胸腔镜术中食管闭合技术。一名女婴在 39 周妊娠时出生，患有长段 EA（五个椎骨）。患者在食管延长后接受了胸腔镜食管吻合术。仔细游离近端和远端食管，但它们之间的距离仍然很长。在上段食管放置了胸外牵引缝线。然后，经口插入 Neraton 导管，将上段食管推挤并张开。在 Neraton 导管和下段食管之间放置内部牵引缝线。通过拉动 Neraton 导管可以使近端和远端食管之间的间隙接近。成功完成了食管吻合术。我们的胸腔镜术中食管闭合技术简单有效。
