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Thoracoscopic external traction suture elongation for the management of long-gap oesophageal atresia: a two-centre experience

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Topic overview

This two-center retrospective study reports outcomes of thoracoscopic external traction suture elongation (Van der Zee technique) in 10 long-gap esophageal atresia patients, with or without distal tracheoesophageal fistula. All patients achieved esophageal continuity without requiring esophagostomy, with median 6 days between first traction and final anastomosis.

Key takeaways

  • Thoracoscopic external traction sutures successfully achieved primary anastomosis in all 10 LGOA cases, avoiding oesophagostomy.
  • Technique works for both pure atresia (Gross A/B) and long-gap cases with distal TOF (type C), median 3 traction procedures needed.
  • Median time from first traction to final anastomosis was 6 days; all patients achieved oral feeding at 12-52 month follow-up.
  • Thoracoscopic approach provides superior visualization and maintains consistent tension after chest closure compared to open techniques.
  • Three anastomotic leaks occurred but were managed conservatively; four cases required conversion to thoracotomy at third procedure.

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How to cite: GlobalCastMD. Thoracoscopic external traction suture elongation for the management of long-gap oesophageal atresia: a two-centre experience. GlobalCastMD Medical Library. 2024-05-20. https://dev.library.globalcastmd.com/article/8643?via_space=staycurrentmd

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