title: Respiratory morbidity and growth after open thoracotomy or thoracoscopic repair of esophageal atresia.
abstract: BACKGROUND
  Respiratory morbidity has been described in patients who underwent repair of esophageal atresia as a neonate. We compared the influence of open thoracotomy or thoracoscopy on lung function, respiratory symptoms, and growth.
  
  
  METHODS
  Functional residual capacity (FRC(p)), indicative of lung volume, and maximal expiratory flow at functional residual capacity (V'max(FRC)), indicative of airway patency, of 37 infants operated for esophageal atresia were measured with Masterscreen Babybody at 6 and 12 months. SD scores were calculated for V'max(FRC).
  
  
  RESULTS
  Repair was by thoracotomy in 21 cases (57%) and by thoracoscopy in 16 cases (43%). Lung function parameters did not differ between the types of surgery (FRC(p); P = .384 and V'max(FRC); P = .241). FRC(p) values were in the upper normal range and increased from 6 to 12 months (22.5 and 25.4 mL/kg respectively, P = .010). Mean (SD) V'max(FRC) was below the norm without significant change in SD scores from 6 to 12 months (-1.9 and -2.3, respectively, P = .248). Neither lung function nor type of repair was associated with clinical evolution up to 2 years.
  
  
  CONCLUSIONS
  Lung function during the first year was similar in EA infants repaired by thoracotomy or thoracoscopy. Ongoing follow-up including pulmonary function testing is needed to determine whether differences occur at a later age in this cohort.
authors.affiliation: Intensive Care and Department of Pediatric Surgery, Erasmus Medical Centre/Sophia Children's Hospital, Rotterdam, The Netherlands. m.spoel@erasmusmc.nl
authors.forename: Marjolein
authors.initials: M
authors.lastname: Spoel
authors.forename: Conny J H M
authors.initials: CJ
authors.lastname: Meeussen
authors.forename: Saskia J
authors.initials: SJ
authors.lastname: Gischler
authors.forename: Wim C J
authors.initials: WC
authors.lastname: Hop
authors.forename: Nikolaas M A
authors.initials: NM
authors.lastname: Bax
authors.forename: Rene M H
authors.initials: RM
authors.lastname: Wijnen
authors.forename: Dick
authors.initials: D
authors.lastname: Tibboel
authors.forename: Johan C
authors.initials: JC
authors.lastname: de Jongste
authors.forename: Hanneke
authors.initials: H
authors.lastname: Ijsselstijn
mesh_terms: D002657:Child Development; D002675:Child, Preschool; D004933:Esophageal Atresia / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D005652:Functional Residual Capacity; D005764:Gastroesophageal Reflux / Q000209:etiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000175:diagnosis / Q000209:etiology*; D008448:Maximal Expiratory Flow Rate; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology*; D013906:Thoracoscopy; D013908:Thoracotomy; D016896:Treatment Outcome