Thoracoscopy versus thoracotomy for esophageal atresia and tracheoesophageal fistula: Outcomes from the Midwest Pediatric Surgery Consortium

Controversy persists regarding the ideal surgical approach for repair of esophageal atresia with tracheoesophageal fistula (EA/TEF). We examined complications and outcomes of infants undergoing thoracoscopy and thoracotomy for repair of Type C EA/TEF using propensity score-based overlap weights to m...

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Published in:Journal of pediatric surgery 2023-01, Vol.58 (1), p.27-33
Main Authors: Marquart, John P., Bowder, Alexis N, Bence, Christina M., St. Peter, Shawn D., Gadepalli, Samir K., Sato, Thomas T., Szabo, Aniko, Minneci, Peter C., Hirschl, Ronald B., Rymeski, Beth A., Downard, Cynthia D., Markel, Troy A., Deans, Katherine J., Fallat, Mary E., Fraser, Jason D., Grabowski, Julia E., Helmrath, Michael A., Kabre, Rashmi D., Kohler, Jonathan E., Landman, Matthew P., Lawrence, Amy E., Leys, Charles M., Mak, Grace Z., Port, Elissa, Saito, Jacqueline, Silverberg, Jared, Slidell, Mark B., Wright, Tiffany N., Lal, Dave R.
Format: Article
Language:English
Subjects:
Child
Constriction, Pathologic - surgery
Esophageal atresia
Esophageal Atresia - complications
Esophageal Atresia - surgery
Humans
Infant
Prospective Studies
Retrospective Studies
Thoracoscopy
Thoracotomy
Tracheoesophageal fistula
Tracheoesophageal Fistula - complications
Tracheoesophageal Fistula - epidemiology
Tracheoesophageal Fistula - surgery
Treatment Outcome
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Summary:Controversy persists regarding the ideal surgical approach for repair of esophageal atresia with tracheoesophageal fistula (EA/TEF). We examined complications and outcomes of infants undergoing thoracoscopy and thoracotomy for repair of Type C EA/TEF using propensity score-based overlap weights to minimize the effects of selection bias. Secondary analysis of two databases from multicenter retrospective and prospective studies examining outcomes of infants with proximal EA and distal TEF who underwent repair at 11 institutions was performed based on surgical approach. Regression analysis using propensity score-based overlap weights was utilized to evaluate outcomes of patients undergoing thoracotomy or thoracoscopy for Type C EA/TEF repair. Of 504 patients included, 448 (89%) underwent thoracotomy and 56 (11%) thoracoscopy. Patients undergoing thoracoscopy were more likely to be full term (37.9 vs. 36.3 weeks estimated gestational age, p 
ISSN:0022-3468
1531-5037
DOI:10.1016/j.jpedsurg.2022.09.015