title: Influence of thoracoscopic esophageal atresia repair on esophageal motor function and gastroesophageal reflux.
abstract: OBJECTIVE
  Thoracoscopic repair has recently been attempted in newborns with esophageal atresia (EA), but it remains unclear whether thoracoscopic dissection reduces pathological gastroesophageal reflux. We investigated the influence of a thoracoscopic approach on esophageal motor function in patients with EA.
  
  
  METHODS
  Clinical and gastrointestinal data of 10 patients with EA with open repair (group A) and 7 with thoracoscopic repair (group B) were analyzed retrospectively. Videomanometry was conducted to investigate esophageal motor patterns. Esophageal acid exposure was evaluated with 24-hour esophageal pH monitoring. Data are expressed as medians and ranges.
  
  
  RESULTS
  Contractions in the distal esophagus were conspicuously absent in 1 and 3 patients in groups A and B, respectively (P = .26). There were no significant differences in esophageal acid exposure (5.5% [0.7%-24.6%] vs 3.7% [0.3%-56.8%]; P = .71) or mean esophageal acid reflux time (0.5 minutes [0.1-1.4 minutes] vs 0.5 minutes [0.1-1.3 minutes]; P = .87) between the 2 groups. Fundoplication was conducted in 2 patients in each group (P = .60), all of whom had conspicuously absent distal esophageal contractions. Those contractions were preserved in the remaining patients with the exception of 1 group B patient.
  
  
  CONCLUSIONS
  There are unlikely to be benefits from thoracoscopic repair of EA in terms of postoperative esophageal motor function.
authors.affiliation: Department of Pediatric Surgery, Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka 594-1101, Japan. kawahara@mch.pref.osaka.jp
authors.forename: Hisayoshi
authors.initials: H
authors.lastname: Kawahara
authors.forename: Hiroomi
authors.initials: H
authors.lastname: Okuyama
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Mitani
authors.forename: Motonari
authors.initials: M
authors.lastname: Nomura
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nose
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yoneda
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Hasegawa
authors.forename: Akio
authors.initials: A
authors.lastname: Kubota
authors.forename: Masahiro
authors.initials: M
authors.lastname: Fukuzawa
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D004933:Esophageal Atresia / Q000601:surgery*; D050782:Esophageal pH Monitoring; D004947:Esophagus / Q000503:physiopathology / Q000601:surgery; D005500:Follow-Up Studies; D018662:Fundoplication / Q000379:methods; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008365:Manometry / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000503:physiopathology / Q000517:prevention & control*; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*; D016896:Treatment Outcome