Clin Pediatr | Volume 2, Issue 1 | Research Article | Open Access
Omid Amanollahi* and Ali Gasemi
Department of Pediatric Surgery, Kermanshah University of Medical Sciences, Iran
*Correspondance to: Omid Amanollahi
Fulltext PDFBackground: Esophageal Atresia and fistula is a congenital anomaly and its treatment is surgically via thoracotomy or thoracoscopy. Its subject of debate that which kind of surgery and esophageal exposure is better, Extrapleural without opening of pleura or transpleural with opening of pleura. It seems that extrapleural route had better prognosis if anastomosis leak occurs and most surgeons prefer this method. In this study we compare the two methods and its results. Material and
Methods: In this retrospective study, 72 neonates in Imam Reza and Mohammad Kermanshahi hospital between March 2007 and March 2014 had been operated due to esophageal atresia (36 male and 36 female neonates) 39 patients with extrapleural and 33 patients with intrapleural method.
Results: Seven anastomosis leaks happened after surgery, from which 6 cases were in intrapleural group. Totally 20 cases died, from which 8 cases were related to extrapleural method and 12 cases from transpleural group. There were 4 cases of T.E. fistula recurrences after surgery from which 3 cases were belongs to intrapleural group (one case died) and only one case from extra pleural group.
Conclusion: Esophageal anastomosis leak after surgery for esophageal atresia in extra pleural method is lesser than intrapleural method and if it occurred, prognosis is better in extrapleural method, probably, due to intact pleura and absence of any relation between leakage site and mediastinum that prohibits infection to spreading within lung and another organ. In addition, better drainage with chest tube in extrapleural method is important in faster repair and improvement
Esophageal atresia; Transpleural repair; Extrapleural repair; Leak of anastomosis
Amanollahi O, Gasemi A. Comparison of Two Transpleural and Extrapleural Surgery Methods in Neonatal Esophageal Atresia. Clin Pediatri. 2019; 2: 1014.