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Thoracoscopy Approach in Prone Position for Esophagoplasty in Children

Camila G Fachin1, Gustavo G Oliveira1, Karin A Becker1

  • 1Pediatric Surgery Department of Federal University of Paraná, Curitiba, Paraná, Brazil.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|November 8, 2021
PubMed

Insights

Congenital esophageal stenosis (CES) is rare, with fibromuscular stenosis (FMS) being a type. Thoracoscopic esophagoplasty offers a safe and effective surgical solution for FMS in children, leading to prompt recovery and good outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Medical Genetics

Background:

  • Congenital esophageal stenosis (CES) is a rare condition affecting 1 in 25,000–50,000 live births.
  • Histological types include tracheobronchial remnants, fibromuscular stenosis (FMS), and membranous stenosis.
  • While conservative dilatation is first-line, it can be ineffective or lead to complications in certain CES types.

Purpose of the Study:

  • To report two cases of fibromuscular stenosis (FMS) treated with thoracoscopic esophagoplasty in children.
  • To evaluate the safety and efficacy of this minimally invasive surgical approach for CES.

Main Methods:

  • Two pediatric patients with distal esophageal FMS presented with dysphagia and feeding refusal.
  • Diagnosis was confirmed via radiological examination.
  • Both underwent thoracoscopic esophagoplasty in the prone position, involving longitudinal incision and transverse synthesis of the stenotic segment.

Main Results:

  • Patients experienced prompt recovery following thoracoscopic esophagoplasty.
  • No recurrent stenosis was observed post-surgery.
  • Both children remained asymptomatic with good diet acceptance.

Conclusions:

  • Thoracoscopic esophagoplasty is a safe and feasible surgical alternative for treating congenital esophageal stenosis (CES), specifically fibromuscular stenosis (FMS), in pediatric patients.
  • This minimally invasive technique facilitates rapid recovery and excellent long-term outcomes.

Keywords:
congenital esophageal stenosisesophagoplastyprone thoracoscopy

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