Clinical analysis of surgery for type III esophageal atresia via thoracoscopy: a study of a Chinese single-center experience

Abstract

Abstract Purpose The purpose of this study was to investigate the effectiveness and safety of the operation for type III esophageal atresia using a thoracoscope. Methods The clinical data for 92 patients with type III esophageal atresia in our hospital from January 2015 to December 2018 were analyzed retrospectively. There were 49 patients in group A who underwent thoracoscopic surgery and 43 patients in group B who underwent conventional surgery. Results The mechanical ventilation time (55.7 ± 11.4 h vs 75.6 ± 19.2 h), intensive care time (3.6 ± 1.8d vs 4.7 ± 2.0d), postoperative hospitalization time (13.1 ± 2.2d vs 16.8 ± 4.3d), thoracic drainage volume (62.7 ± 25.5 ml vs 125.4 ± 46.1 ml), blood transfusion volume (30.5 ± 10.4 ml vs 55.3 ± 22.7 ml) and surgical incision length (2.0 ± 0.5 cm vs 8.0 ± 1.8 cm) in group A were lower than those in group B, and the differences were statistically significant (P < 0.05). Among the postoperative complications, the incidences of postoperative severe pneumonia (8.2% vs 23.3%), poor wound healing (2.0% vs 14.0%) and chest wall deformity (0% vs 11.6%) in group A were significantly lower than those in group B (P < 0.05). There was no significant difference in the incidence of anastomotic stricture, tracheomalacia or gastroesophageal reflux between the two groups after surgery and early during follow-up (P > 0.05), and there were no complications such as achalasia signs and esophageal diverticulum in either group. Conclusion Surgery for type III esophageal atresia via thoracoscopy has the same safety and clinical effectiveness as traditional surgery and has the advantages of smaller incision and chest wall deformity.