title: Endoscopic repair of laryngotracheoesophageal clefts.
abstract: OBJECTIVE
  In Japan, surgical repair of a laryngotracheoesophageal cleft (LTEC) typically consists of the anterior approach, with the lateral approach as an alternative. Endoscopic surgery to repair the tracheoesophageal septum has been reported, and this study reviewed our experience treating several cases of LTEC endoscopically.
  
  
  METHODS
  Endoscopic repair of LTEC was performed in 7 patients (3 boys, 4 girls; age range 4 months to 2 years 10 months; mean age 11 months; mean weight at surgery 7.23 kg; weight range 3.85-12.24 kg) between 2009 and 2014. LTEC was type I in 5 patients and types II and IV in 1 patient each. The patient with type IV was first operated on by the lateral approach, and the remaining cleft, which level was type III, was repaired endoscopically. Postoperative outcomes were retrospectively studied.
  
  
  RESULTS
  Endoscopic surgery was successful in all patients. All 6 patients with types I and II LTEC were extubated easily, while in the patient with type IV LTEC, it was difficult to remove the tracheostomy cannula because of tracheomalacia. Postoperatively, tracheostomy cannulation became more stable, and the patient is gradually being weaned off the ventilator. All patients could be fed orally without difficulty postoperatively.
  
  
  CONCLUSIONS
  Endoscopic surgery provides a view from the cephalic aspect permitting the surgeon to form a normal larynx with only minimal risk of complications.
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan. Electronic address: koji-fukumoto@i.shizuoka-pho.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Miyano
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Yamoto
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nouso
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Kaneshiro
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nakajima
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Koyama
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, Kanagawa, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Mochizuki
authors.affiliation: Department of Surgery, Kanagawa Children's Medical Center, Kanagawa, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Shinkai
authors.affiliation: Department of Surgery, Shizuoka Children's Hospital, Shizuoka, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
mesh_terms: D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000601:surgery*; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D004947:Esophagus / Q000002:abnormalities* / Q000601:surgery*; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D007830:Larynx / Q000002:abnormalities* / Q000601:surgery; D008297:Male; D012189:Retrospective Studies; D014132:Trachea / Q000002:abnormalities* / Q000601:surgery*; D014139:Tracheostomy
keywords: Complications; Endoscopic surgery; Laryngotracheoesophageal cleft (LTEC)