title: Thoracoscopic repair of oesophageal atresia: experience of 33 patients from two tertiary referral centres.
abstract: BACKGROUND
  With advances in minimally invasive surgery, thoracoscopic repair of oesophageal atresia has become popular in many centres worldwide and indeed has been described as the pinnacle of neonatal surgery. Here, we report our experience in two tertiary referral centres.
  
  
  METHODS
  Thoracoscopic technique was introduced in 2007. Thus, a retrospective review of all patients diagnosed with oesophageal atresia was carried out. Patients who had thoracoscopic repair were included, and those who had open repair due to co-morbidities were excluded. Patient demographics, operative data, complications, and associated anomalies were noted.
  
  
  RESULTS
  A total of thirty-three patients underwent thoracoscopic repair during the time period. Thirty-one were successfully repaired thoracoscopically. Two patients had conversions due to intra-operative instability. The mean body weight of the neonates was 2.58 kg. The mean operative time was 146 min. Three patients suffered from minor anastomotic leaks, which healed on conservative management. Seven patients had anastomotic strictures, which responded successfully to endoscopic dilatation. Two patients died in the post-operative period due to pneumonia. One patient had a recurrent fistula 3 months after the primary repair, and he subsequently underwent a successful second repair.
  
  
  CONCLUSIONS
  In experienced hands, thoracoscopic repair of oesophageal atresia is at least as good as open surgery but with less surgical trauma. Standard of post-operative care contributes significantly to post-operative outcome. Thoracoscopic technique is now our preferred approach.
authors.affiliation: Department of Surgery, Jiangxi Children Hospital, Nanchang 330006, China.
authors.forename: Jinshi
authors.initials: J
authors.lastname: Huang
authors.forename: Junfeng
authors.initials: J
authors.lastname: Tao
authors.forename: Kuai
authors.initials: K
authors.lastname: Chen
authors.forename: Kanglin
authors.initials: K
authors.lastname: Dai
authors.forename: Qiang
authors.initials: Q
authors.lastname: Tao
authors.forename: I H Y
authors.initials: IH
authors.lastname: Chan
authors.forename: P H Y
authors.initials: PH
authors.lastname: Chung
authors.forename: L C L
authors.initials: LC
authors.lastname: Lan
authors.forename: P K H
authors.initials: PK
authors.lastname: Tam
authors.forename: Kenneth K Y
authors.initials: KK
authors.lastname: Wong
mesh_terms: D002681:China; D015331:Cohort Studies; D004933:Esophageal Atresia / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D004940:Esophageal Stenosis / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D062606:Tertiary Care Centers; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D014138:Tracheoesophageal Fistula / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome