Comparison of thoracotomy and thoracoscopy in patients with esophageal atresia - tracheoesophageal fistula

Abstract

Objective: The aim of this study was to compare the patients who underwent EA-TEF repair with both classical and thoracoscopic methods, and thus to reveal the advantages and disadvantages of both techniques. Materials and methods: In this study, the files of 45 patients who underwent surgery for EA-TEF at the Erciyes University Faculty of Medicine (EUFM) Pediatric Surgery Clinic between August 2005 and July 2012 were retrospectively examined. Patients were divided into two groups based on the surgical method applied. Results: A total of 45 patients who presented with EA-TEF and underwent surgical procedures were evaluated. Thirty-one (70%) patients underwent thoracotomy (Group I), and 14 (30%) patients underwent surgery using the thoracoscopic method (Group II). The average gestational age was 37.5 weeks, and the birth weight was 2600 grams. Nineteen (42%) of the patients were female, and 26 (58%) were male. Group I was 39 weeks and 38 weeks in Group II. There was no significant difference in gestational age between the two groups (p>0.05). There was no significant difference between the groups regarding accompanying system anomalies (p>0.05). The time to surgery for patients in both groups was 2 days (p>0.05). The operation time in Group I (95 minutes) was shorter than in Group II (105 minutes) (p<0.05). The time to start gavage feeding after surgery in Group II was shorter compared to Group I (p<0.05). No difference was detected between the groups concerning the time to start oral feeding (p>0.05). No difference was detected between the groups concerning the length of hospital stay (p>0.05). There was no significant difference between the groups regarding the rate of complications (p>0.05). No patient died during surgery. Eleven (35%) of the 31 patients in Group I and 2 (14%) of the 14 patients in Group II died between postoperative days 1 and 25. There was no difference in mortality rates between the groups (p>0.05). Conclusions: Postoperative complications were detected at similar rates in both groups

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