title: Foregut duplications: is there an advantage to thoracoscopic resection?
abstract: OBJECTIVE
  Thoracoscopy has an expanding role in the treatment of FD cysts (bronchogenic cysts and esophageal duplications). We examined this trend in our patients and reviewed our overall experience.
  
  
  METHODS
  All charts of children undergoing surgery for foregut duplications (FDs) in 2 pediatric hospitals between 1992 and 2003 were retrospectively reviewed. Data gathered included age, weight, symptoms, diagnostic tests, operative technique, postoperative course, complications, and outcome.
  
  
  RESULTS
  There were 39 children, with FD resected by thoracotomy in 21 patients, thoracoscopy in 11 patients (no conversions to open), cervical incision in 6 patients, and laparotomy in 1 patient for an FD near the gastroesophageal junction. Diagnosis was made by antenatal ultrasound in 7 cases. Four of these neonates had tachypnea or cough, and the rest were asymptomatic. Seventy-five percent of patients diagnosed postnatally presented with respiratory symptoms. Excision of isolated FD (without lung resection) was compared between those who had a thoracotomy (n = 16) vs thoracoscopy (n = 11). The age, weight, operating time, and anesthesia time were not different between the 2 groups. However, the thoracoscopy group had significantly fewer chest tube days (1.6 vs 3.3 days) and a shorter hospital stay (2.6 vs 6.6 days). Intraoperative complications consisted of tracheal injury in 3 patients (2 thoracotomy, 1 thoracoscopy) and esophageal mucosal injury in 2 patients (both thoracotomy), which were all recognized and repaired.
  
  
  CONCLUSIONS
  Foregut duplications may present in a variety of ways and locations. Thoracoscopy is advantageous for isolated intrathoracic FDs.
authors.affiliation: Division of Pediatric Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, H3H-1P3, Canada.
authors.forename: Ioana
authors.initials: I
authors.lastname: Bratu
authors.forename: Jean-Martin
authors.initials: JM
authors.lastname: Laberge
authors.forename: Helene
authors.initials: H
authors.lastname: Flageole
authors.forename: Sarah
authors.initials: S
authors.lastname: Bouchard
mesh_terms: D000293:Adolescent; D001994:Bronchogenic Cyst / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004935:Esophageal Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D004947:Esophagus / Q000002:abnormalities / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D016216:Ultrasonography, Prenatal