Are Low Weight or Cardiopathy Contraindications for Thoracoscopic Repair of Esophageal Atresia with Tracheoesophageal Fistula?

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Key takeaways

• Thoracoscopic EA/TEF repair is feasible in neonates with major congenital heart disease without increased complications or conversion rates.
• Low birth weight (<2000g) is not an absolute contraindication; only 1/25 patients required conversion due to anesthetic intolerance at 1050g.
• Operative time, anastomotic outcomes, and stricture rates were comparable between high-risk (CHD/LBW) and standard-risk patient groups.
• No TEF recurrence occurred in either group, supporting thoracoscopic approach safety when individualized appropriately.
• Patient selection remains critical—individualize indication based on anesthetic tolerance and institutional expertise with complex cases.

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