Current Patterns of Practice and Technique in the Repair of Esophageal Atresia and Tracheoesophageal Fistua: An IPEG Survey

Lal, Dave R.; Miyano, Go; Juang, David; Sharp, Nicole E.; Peter, Shawn D. St.

doi:10.1089/lap.2013.0210

Cited by 84 publications

(49 citation statements)

References 12 publications

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“…The repair has always been performed by thoracotomy, but is increasingly performed by thoracoscopy [1, 2]. Since no randomized controlled trial has been done, the debate on the best method to repair the esophageal atresia still continues [3].…”

Section: Introductionmentioning

confidence: 99%

Brain Oxygenation During Thoracoscopic Repair of Long Gap Esophageal Atresia

et al. 2017

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BackgroundElongation and repair of long gap esophageal atresia (LGEA) can be performed thoracoscopically, even directly after birth. The effect of thoracoscopic CO2-insufflation on cerebral oxygenation (rScO2) during the consecutive thoracoscopic procedures in repair of LGEA was evaluated.MethodsProspective case series of five infants, with in total 16 repetitive thoracoscopic procedures. A CO2-pneumothorax was installed with a pressure of maximum 5 mmHg and flow of 1 L/min. Parameters influencing rScO2 were monitored. For analysis 10 time periods of 10’ during surgery and in the perioperative period were selected.ResultsMedian gestational age was 35+3 [range 33+4 to 39+6] weeks; postnatal age at time of first procedure 4 [2–53] days and time of insufflation 127[22–425] min. Median rScO2 varied between 55 and 90%. Transient outliers in cerebral oxygenation were observed in three patients. In Patient 2 oxygenation values below 55% occurred during a low MABP and Hb < 6 mmol/L. The rScO2 increased after erythrocytes transfusion. Patient 5 also showed a rScO2 of 50% with a Hb <6 mmol/L during all procedures, except for a substantial increase during a high paCO2 of 60 mmHg. Patient 4 had a rScO2 > 85% during the first procedure with a concomitant high FiO2 > 45%. All parameters recovered during the surgical course.ConclusionsThis prospective case series of NIRS during consecutive thoracoscopic repair of LGEA showed that cerebral oxygenation remained stable. Transient outliers in rScO2 occurred during changes in hemodynamic or respiratory parameters and normalized after interventions of the anesthesiologist. This study underlines the importance of perioperative neuromonitoring and the close collaboration between pediatric surgeon, anesthesiologist and neonatologist.Electronic supplementary materialThe online version of this article (doi:10.1007/s00268-016-3853-y) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Brain Oxygenation During Thoracoscopic Repair of Long Gap Esophageal Atresia

et al. 2017

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“…According to IPEG and EUPSA survey thoracoscopic esophageal repair is worldwide accepted procedure and being performed in more than 65 developed centers [6,7]. In few Asian countries and Middle East, thoracoscopic repair of esophageal atresia has been started but they are at initial learning stage [8][9][10].…”

Section: Discussionmentioning

confidence: 99%

Thoracoscopic Esophageal Atresia Repair in Pakistan: Early Learning Curve

Brohi¹,

Mengal²,

Tabassum³

2017

J Neonat Surg

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How to cite: Brohi AR, Mengal N, Tabassum R. Thoracoscopic esophageal atresia repair in Pakistan: early learning curve.J Neonatal Surg. 2017;6:78.This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACTBackground: Esophageal atresia is rare congenital anomaly, which is traditionally repaired by open thoracotomy. Thoracoscopic esophageal atresia repair has evolved as an effective and safe technique.

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“…7 Because of the small number of cases being completed by individual practitioners, there is a need for multi-institutional studies to achieve data that can lead to best practices. This is the first study to examine the nationwide variability in thoracoscopic management of patients with EA/TEF in Japan.…”

Section: Discussionmentioning

confidence: 99%