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Thoracoscopic repair of esophageal atresia with right-sided aortic arch: systematic review

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Abstract

Objective

Thoracoscopic repair of esophageal atresia (EA) in the presence of right aortic arch (RAA) in neonates is still not widely reported due to its rare prevalence. This systematic review was performed for thoracoscopic repair of EA and RAA in the past two decades.

Methods

PubMed, Google Scholar, and Science Direct databases were searched for articles on children with the thoracoscopic repair of EA and RAA published between 2002 and 2023. Data were extracted with regards to number of patients, preoperative diagnosis and approach, intraoperative diagnosis and approach, conversion, morbidity, and mortality.

Results

The review identified 8 articles and offered a total of 22 neonates with EA and RAA with attempted thoracoscopic repair. Data extrapolated showed (a) preoperative diagnosis confirmation (n = 10), (b) approach with confirmed preoperative diagnosis: right thoracoscopy (n = 5), left thoracoscopy (n = 5), (c) intraoperative diagnosis (n = 12), (d) approach after intraoperative diagnosis: shift right thoracoscopy to left thoracoscopy (n = 6), right thoracoscopy (n = 6), open conversion (n = 2), (e) total conversions: total (n = 4): thoracotomy (n = 2), right thoracoscopy to left thoracoscopy and then right thoracotomy (n = 1), to left thoracotomy (n = 1), (f) repair outcomes: primary repairs (n = 17) and staged repair (n = 5),(g) morbidity: leaks( n = 2), stricture (n = 1), no data (n = 11) and (h) mortality (n = 3).

Conclusion

There is an equal distribution in the side of approach in EA with preoperative diagnosis of RAA. This is also evident when the findings are confirmed intraoperatively. In 50% of the cases with intraoperative RAA findings, a switch to the left side was preferred. Conversions are reported in approximately 14% cases.

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Data availability

Data analyzed in this study has been included in the references.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Chelsea and Westminster Hospital NHS Foundation Trust, Imperial College London, 369 Fulham Road, London, SW10 9NH, UK

    Sherine Elsherbiny & Amulya K. Saxena

  2. Department of Pediatric Surgery, University of Magdeburg, Magdeburg, Germany

    Sherine Elsherbiny

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  1. Sherine Elsherbiny
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  2. Amulya K. Saxena
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Correspondence to Amulya K. Saxena.

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Elsherbiny, S., Saxena, A.K. Thoracoscopic repair of esophageal atresia with right-sided aortic arch: systematic review. J Ped Endosc Surg 5, 165–169 (2023). https://doi.org/10.1007/s42804-023-00206-8

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  • DOI: https://doi.org/10.1007/s42804-023-00206-8

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