ArticlePediatric surgery international2025
Staged thoracoscopic internal traction approach for early repair of long-gap esophageal atresia (LGEA) with distal tracheoesophageal fistula (TEF).
Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- The application of stay sutures in thoracoscopic esophageal repair for Type C esophageal atresia.Pediatric surgery international · 2025Trial
- Surgical Strategies for Native Esophagus Preservation in Long-Gap Esophageal Atresia: A 20-Year Population-Based Study.Journal of clinical medicine · 2026Article
- Preservation of the Native Esophagus in Long-Gap Esophageal Atresia: Case Presentation.Cureus · 2026Article
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10 authors.
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Abstract
backgroundLong-gap esophageal atresia (LGEA) can complicate the management of esophageal atresia (EA) with or without a tracheoesophageal fistula (TEF). This series describes a short interval, staged, thoracoscopic internal traction approach for LGEA with distal TEF to manage complex anastomotic tension or an anatomically impossible esophageal anastomosis.
methodsA retrospective review (2018-2024) was performed across four tertiary centers to identify patients with LGEA and distal TEF, managed with a staged, thoracoscopic internal traction approach. In the first stage, the TEF was ligated and internal traction sutures were placed between esophageal pouches. In the second stage, patients underwent primary anastomosis. Short and long-term complications and outcomes were measured.
resultsIn total, seven patients were treated with this approach. Gestational ages ranged from 33 to 39 weeks. The average age at the initial surgery was 2.3 days, and the average age at definitive anastomosis was 15.9 days. There were no cases of leak or esophageal dehiscence. Gastroesophageal reflux was a common post-operative complication, occurring in 85.7% of patients.
conclusionsTemporary internal traction sutures allow for a minimally invasive, safe repair of LGEA with distal TEF, under decreased tension. This technique reduces operative time, and potential complications associated with other long-gap anastomotic techniques. LEVEL OF EVIDENCE: IV.
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