Endoscope-assisted resection of second branchial cleft fistula via the anterior chest approach

Traditional resection of second branchial cleft fistulas (SBCFs) involves a transcervical incision in the neck, which leaves a prominent scar; therefore, endoscope-assisted excision of SBCFs through the anterior chest approach has been proposed. To introduce endoscope-assisted excision of SBCFs via the anterior chest approach and to evaluate its feasibility, validity, safety, and clinical results.

This was a study of four patients with SBCFs who underwent surgical resection with the assistance of endoscopy via the anterior chest approach between May 2012 and May 2018.

All procedures were successfully performed with endoscope-assisted surgery via the anterior chest approach. The volume of blood loss ranged from 5 to 10 mL (median 6 ml). The operating time ranged from 45 to 67 min (median 50 min). No patients presented evidence of long-term complications or recurrence during the median follow-up period of 72-144 months (median 99 months). All patients were satisfied with the cosmetic outcomes.

Endoscope-assisted resection of SBCFs via the anterior chest approach is feasible, effective, and safe and has better esthetic effects. Therefore, SBCF surgery via the anterior chest approach could be a novel and superior treatment option for patients with SBCFs.