2026-04-13T02:20:26Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/127782025-10-24T10:36:04Zcom_2072_378070com_2072_378040col_2072_378092

2025-10-24T10:36:04Z urn:hdl:11351/12778 Staged thoracoscopic internal traction approach for early repair of long-gap esophageal atresia (LGEA) with distal tracheoesophageal fistula (TEF) Sajankila, Nitin Gigena Heitsman, Cecilia Zamorano, Darling Santos, Marcela Gómez Sánchez, Alicia Lavado, Isidora López Paredes, Manuel Infants nadons Fístules Avaluació de resultats (Assistència sanitària) Sutures (Cirurgia) Endoscòpia Malformacions Aparell digestiu - Malformacions DISEASES::Digestive System Diseases::Digestive System Abnormalities::Esophageal Atresia Other subheadings::Other subheadings::Other subheadings::/surgery ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Wound Closure Techniques::Suture Techniques ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Minimally Invasive Surgical Procedures::Endoscopy::Surgical Procedures, Operative::Thoracoscopy DISEASES::Digestive System Diseases::Digestive System Fistula::Esophageal Fistula::Tracheoesophageal Fistula Other subheadings::Other subheadings::Other subheadings::/surgery NAMED GROUPS::Persons::Age Groups::Infant::Infant, Newborn ENFERMEDADES::enfermedades del sistema digestivo::anomalías del sistema digestivo::atresia esofágica Otros calificadores::Otros calificadores::Otros calificadores::/cirugía TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::técnicas de cierre de heridas::técnicas de sutura TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos quirúrgicos mínimamente invasivos::endoscopia::intervenciones quirúrgicas::toracoscopia ENFERMEDADES::enfermedades del sistema digestivo::fístula del sistema digestivo::fístula esofágica::fístula traqueoesofágica Otros calificadores::Otros calificadores::Otros calificadores::/cirugía DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::lactante::recién nacido Esophageal Atresia; Thoracoscopic surgery; Tracheoesophageal fistula Atresia esofàgica; Cirurgia toracoscòpica; Fístula traqueoesofàgica Atresia esofágica; Cirugía toracoscópica; Fístula traqueoesofágica Background Long-gap esophageal atresia (LGEA) can complicate the management of esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF). This series describes a short interval, staged, thoracoscopic internal traction approach for LGEA with distal TEF to manage complex anastomotic tension or an anatomically impossible esophageal anastomosis. Methods A retrospective review (2018–2024) was performed across four tertiary centers to identify patients with LGEA and distal TEF, managed with a staged, thoracoscopic internal traction approach. In the first stage, the TEF was ligated and internal traction sutures were placed between esophageal pouches. In the second stage, patients underwent primary anastomosis. Short and long-term complications and outcomes were measured. Results In total, seven patients were treated with this approach. Gestational ages ranged from 33 to 39 weeks. The average age at the initial surgery was 2.3 days, and the average age at definitive anastomosis was 15.9 days. There were no cases of leak or esophageal dehiscence. Gastroesophageal reflux was a common post-operative complication, occurring in 85.7% of patients. Conclusions Temporary internal traction sutures allow for a minimally invasive, safe repair of LGEA with distal TEF, under decreased tension. This technique reduces operative time, and potential complications associated with other long-gap anastomotic techniques. Level of evidence IV. 2025-10-24T10:36:04Z 2025-10-24T10:36:04Z 2025-03-18T08:54:07Z 2025-03-18T08:54:07Z 2025-01-23 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/12778 Pediatric Surgery International;41(1) https://doi.org/10.1007/s00383-025-05973-4 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Springer Scientia