Zhu Shichun, Liu Zhenyong, Li Bing
Department of Pediatric Surgery, Affiliated Hospital of Yangzhou University, Yangzhou, China.
Department of Pediatric Surgery, Huai'an Maternal and Child Health Care Hospital Affiliated to Yangzhou University, Huai'an, China.
Pediatr Surg Int. 2025 Apr 12;41(1):114. doi: 10.1007/s00383-025-06015-9.
To determine whether continuous clamping improves distal fistula dissection in thoracoscopic type C esophageal atresia repair.
Between January 2019 and May 2024, 31 patients with type C esophageal atresia underwent thoracoscopic repair. Patients were randomly assigned to receive either conventional surgery (control group, n = 16) or surgery with continuous clamping during distal fistula dissection (study group, n = 15). This study compared intraoperative parameters (fistula dissection time, total surgical duration, etc.) and postoperative outcomes (anastomotic leak, anastomotic stenosis, etc.) between groups.
Baseline characteristics did not differ significantly between groups, including gender, age, admission weight, gestational age, and comorbid congenital anomalies (all P > 0.05). The study group demonstrated significantly fewer intraoperative interruptions (1.2 ± 0.3 vs. 5.5 ± 1.3 episodes, P < 0.05), shorter fistula ligation time (15.3 ± 4.5 vs. 32.3 ± 10.6 min), and shorter total operative duration (121.5 ± 13.5 vs. 153.1 ± 15.0 min) compared with the control group (all P < 0.05).
Continuous clamping during distal fistula dissection significantly reduces cyanosis-related surgical pauses, shortens fistula ligation time, and decreases total operative time, improving efficiency in thoracoscopic type C esophageal atresia repair.
确定在胸腔镜下C型食管闭锁修复术中持续钳夹是否能改善远端瘘管的分离。
2019年1月至2024年5月期间，31例C型食管闭锁患者接受了胸腔镜修复术。患者被随机分配接受传统手术（对照组，n = 16）或在远端瘘管分离期间进行持续钳夹的手术（研究组，n = 15）。本研究比较了两组之间的术中参数（瘘管分离时间、总手术时间等）和术后结果（吻合口漏、吻合口狭窄等）。
两组之间的基线特征无显著差异，包括性别、年龄、入院体重、孕周和合并的先天性异常（所有P > 0.05）。与对照组相比，研究组术中中断明显更少（1.2 ± 0.3次对5.5 ± 1.3次，P < 0.05），瘘管结扎时间更短（15.3 ± 4.5分钟对32.3 ± 10.6分钟），总手术时间更短（121.5 ± 13.5分钟对153.1 ± 15.0分钟）（所有P < 0.05）。
在远端瘘管分离期间持续钳夹可显著减少与青紫相关的手术停顿，缩短瘘管结扎时间，并减少总手术时间，提高胸腔镜下C型食管闭锁修复术的效率。
