Thoracoscopic Correction of Esophagal Atresia in Dagestan

Introduction: The results of our experience in the treatment of children with esophageal atresia with thoracoscopic access are presented. Materials and methods: From 2020 to 2022, 25 children with EA were operated on at the N.M. Kuraev Medical Center in Makhachkala. Thoracoscopy was performed on 17 children: 13 patients underwent primary anastomosis of the esophagus, 3 had a gastrostomy after TPS ligation, 1 child with a non-esophageal form of AP had internal traction sutures applied to the proximal and distal ends of the esophagus without a gastrostomy. 13 patients with primary anastomosis of the esophagus 3 underwent conversion. 1 child with a non-esophageal form of AP I stage internal traction sutures were applied to the proximal and distal ends of the esophagus without the imposition of gastrostomy. A thoracoscopic anastomosis of the esophagus was applied to 1 child with a non-esophageal form of EA on day 6 after internal traction sutures of stage II. Thus, the analysis was carried out in 10 patients with primary and 1 with delayed anastomosis of the esophagus by thoracoscopic access. Results: The results of treatment of children with EA after thoracoscopic anastomosis of the esophagus were evaluated. Discussion: Analyzing the results of thoracoscopic EA correction according to literary sources, a good cosmetic effect is noted in the early and especially in the long-term postoperative period with a low frequency of musculoskeletal deformity. A serious problem for most pediatric surgeons remains the impossibility of creating a primary anastomosis in the newborn period. In our case, the only obstacle was a large diastasis between the segments of the esophagus. Kozlov et al. a new therapeutic approach was reported for two newborns with EA, consisting in the fact that thoracoscopic traction elongation of the esophagus is possible without gastrostomy, followed by esophago-esophagoanastomosis for 5 and 6 days respectively. According to their work, only anastomosis stenosis was observed in both cases, which we also observed in 1 case. Conclusion. The use of the thoracoscopic method of esophago-esophagoanastomosis provides low trauma, creates a good visualization of the surgical field, achieving a good cosmetic effect, does not form gross scarring and musculoskeletal deformities.