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Purpose <p>Thoracoscopic internal traction (IT) has shown promise in management of long gap oesophageal atresia (LGOA) with distinct advantages. We present our 10-year experience and outcomes.</p> Methods <p>Case files, imaging records, and operative notes of all patients in our centre with LGOA from 2014 to 2024 were reviewed retrospectively. Data collected included: demographics, gap length, surgical details, complications, and follow-up. Data are presented as median (range).</p> Results <p>Seven of nine patients (78%) intended for IT underwent the procedure: one underwent primary anastomosis due to a short gap, and one gastric transposition due to absence of distal pouch. All patients underwent Stamm gastrostomy. Six were female, gestational age was 37&#xa0;weeks (34–38), and birth weight 2.55&#xa0;kg (2.13–3.30). Median follow-up was 3.7&#xa0;years (0.5–11.2). Age at IT was 35&#xa0;days (12–177). Gap length was 5.5 (4.5–7) vertebral bodies (VB), reducing to 1.5VB (0–2) after pouch dissection and traction suture. One patient required a second stage of IT before anastomosis. None had pouch leak or rupture following IT. Anastomosis was achieved in all patients. Anastomotic leak occurred in 1/7 patients (14%), and 6/7 patients (86%) required median 1.5 oesophageal dilatations (1–6). None required unplanned operation or thoracotomy at any stage. Median length of stay was 3.4&#xa0;months (1.5–11.6). Full oral feeding was achieved in 6/7 patients (86%) at age 7.5&#xa0;months (2–38). None required anti-reflux procedures.</p> Conclusion <p>We demonstrate that where IT is feasible it allows preservation of native oesophagus with no conversion to thoracotomy, low rates of anastomotic complications, and high rate of establishment of full oral feeding.</p>

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Thoracoscopic internal traction for long gap oesophageal atresia: 10-year experience from a single centre

  • 期刊论文

  • 发表日期：

    2026年3月9日

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  • Cameron Kuronen-Stewart,
  • Jenna Volpert,
  • Jimmy Lam,
  • Dipankar Dass,
  • Philip Hammond,
  • Fraser Munro,
  • Paul Cullis

摘要

Purpose

Thoracoscopic internal traction (IT) has shown promise in management of long gap oesophageal atresia (LGOA) with distinct advantages. We present our 10-year experience and outcomes.

Methods

Case files, imaging records, and operative notes of all patients in our centre with LGOA from 2014 to 2024 were reviewed retrospectively. Data collected included: demographics, gap length, surgical details, complications, and follow-up. Data are presented as median (range).

Results

Seven of nine patients (78%) intended for IT underwent the procedure: one underwent primary anastomosis due to a short gap, and one gastric transposition due to absence of distal pouch. All patients underwent Stamm gastrostomy. Six were female, gestational age was 37 weeks (34–38), and birth weight 2.55 kg (2.13–3.30). Median follow-up was 3.7 years (0.5–11.2). Age at IT was 35 days (12–177). Gap length was 5.5 (4.5–7) vertebral bodies (VB), reducing to 1.5VB (0–2) after pouch dissection and traction suture. One patient required a second stage of IT before anastomosis. None had pouch leak or rupture following IT. Anastomosis was achieved in all patients. Anastomotic leak occurred in 1/7 patients (14%), and 6/7 patients (86%) required median 1.5 oesophageal dilatations (1–6). None required unplanned operation or thoracotomy at any stage. Median length of stay was 3.4 months (1.5–11.6). Full oral feeding was achieved in 6/7 patients (86%) at age 7.5 months (2–38). None required anti-reflux procedures.

Conclusion

We demonstrate that where IT is feasible it allows preservation of native oesophagus with no conversion to thoracotomy, low rates of anastomotic complications, and high rate of establishment of full oral feeding.