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Thoracoscopic esophagectomy in children.

E K Cury1, V Schraibman, A L De Vasconcelos Macedo

  • 1Hospital Israelita Albert Einstein and the Division of Pediatric Surgery, Department of Surgery, Federal University of São Paulo, São Paulo, Brazil.

Journal of Pediatric Surgery
|August 31, 2001
PubMed
Summary

This study reports the first successful thoracoscopic esophagectomy in children for benign esophageal lesions. This minimally invasive approach offers benefits like reduced pain and shorter hospital stays, mirroring adult outcomes.

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Area of Science:

  • Pediatric Surgery
  • Thoracic Surgery
  • Minimally Invasive Surgery

Background:

  • Minimal access surgery, including thoracoscopic surgery, is an established alternative to open surgery for esophageal resections in adults.
  • While extensively documented in adults for benign and malignant esophageal conditions, thoracoscopic esophagectomy in pediatric patients remains largely undescribed.

Observation:

  • This report details two pediatric cases involving benign esophageal lesions requiring esophagectomy.
  • Case 1: Esophageal stricture post-caustic soda ingestion. Case 2: Esophageal stenosis secondary to thyroglossal duct complication.
  • Both pediatric patients underwent successful thoracoscopic esophagectomy, combined with laparotomy and open cervical exploration.

Findings:

  • The pediatric cases demonstrated significant advantages comparable to those observed in adults undergoing thoracoscopic esophagectomy.

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  • Potential benefits include a shorter hospital stay, enhanced precision in mediastinal structure dissection, reduced postoperative pain, and minimized intraoperative blood loss.
  • Long-term discomfort was also noted to be less compared to open procedures.

    • Implications:

    • Thoracoscopic esophagectomy is a feasible and beneficial minimally invasive surgical option for pediatric patients with benign esophageal lesions.
    • Successful implementation requires specialized medical centers and surgeons with extensive experience in both open and minimally invasive esophagectomy.
    • This approach holds promise for improving outcomes and recovery for children undergoing esophageal surgery.