title: Two-Stage Thoracoscopic Repair of Long-Gap Esophageal Atresia Using Internal Traction Is Safe and Feasible.
abstract: BACKGROUND
  The treatment of long-gap esophageal atresia remains an issue for pediatric surgeons. Many techniques for treating long-gap esophageal atresia have been proposed, but the optimal method has not been established. The thoracoscopic esophageal elongation technique has recently been developed. We previously reported a case in which two-stage thoracoscopic repair was performed using internal esophageal traction without esophageal tearing, and we retrospectively reviewed the outcomes of this procedure in this study.
  
  
  METHODS
  Five patients underwent thoracoscopic treatment involving internal esophageal traction for esophageal atresia involving a long gap or vascular ring over a 5-year period.
  
  
  RESULTS
  Between November 2010 and November 2015, 5 patients were treated with thoracoscopic traction. All of these patients successfully underwent thoracoscopic-delayed primary anastomosis. Conversion to open thoracotomy was not required in any case. The postoperative complications experienced by the patients included minor anastomotic leakage in 2 cases, anastomotic stenosis in 1 case, gastroesophageal reflux (GER) in 4 cases, and a hiatal hernia in 1 case. None of the patients died.
  
  
  CONCLUSIONS
  Two-stage thoracoscopic repair for esophageal atresia involving a long gap or vascular ring is a safe and feasible procedure; however, we must develop methods for treating minor anastomotic complications and GER due to esophageal traction in future.
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Takahisa
authors: T
authors: Tainaka
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Hiroo
authors: H
authors: Uchida
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Akihide
authors: A
authors: Tanano
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Chiyoe
authors: C
authors: Shirota
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Akinari
authors: A
authors: Hinoki
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Naruhiko
authors: N
authors: Murase
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Kazuki
authors: K
authors: Yokota
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Kazuo
authors: K
authors: Oshima
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Ryo
authors: R
authors: Shirotsuki
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .
authors: Kosuke
authors: K
authors: Chiba
authors: 2 Department of Pediatric Surgery, Saitama Children's Medical Center , Saitama, Japan .
authors: Hizuru
authors: H
authors: Amano
authors: 2 Department of Pediatric Surgery, Saitama Children's Medical Center , Saitama, Japan .
authors: Hiroshi
authors: H
authors: Kawashima
authors: 1 Department of Pediatric Surgery, Nagoya University Graduate School of Medicine , Nagoya, Japan .|2 Department of Pediatric Surgery, Saitama Children's Medical Center , Saitama, Japan .
authors: Yujiro
authors: Y
authors: Tanaka
mesh_terms: D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D057868:Anastomotic Leak / Q000209:etiology; D003251:Constriction, Pathologic / Q000209:etiology; D004933:Esophageal Atresia / Q000601:surgery*; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005764:Gastroesophageal Reflux / Q000209:etiology; D006551:Hernia, Hiatal / Q000209:etiology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D014138:Tracheoesophageal Fistula / Q000601:surgery; D014143:Traction / Q000009:adverse effects
keywords: esophageal atresia; long gap; thoracoscopic repair; traction