Influence of thoracoscopic esophageal atresia repair on esophageal motor function and gastroesophageal reflux

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• 作者：Hisayoshi Kawahara ; Hiroomi Okuyama ; Yasuyuki Mitani ; Motonari Nomura ; Keisuke Nose ; Akihiro Yoneda ; Toshimichi Hasegawa ; Akio Kubota ; Masahiro Fukuzawa
• 关键词：Esophageal atresia ; Gastroesophageal reflux ; Thoracoscopic repair ; Videomanometry ; 24-Hour esophageal pH monitoring
• 刊名：Journal of Pediatric Surgery
• 出版年：2009
• 出版时间：December 2009
• 年：2009
• 卷：44
• 期：12
• 页码：2282-2286
• 全文大小：102 K

文摘

Background/Purpose

Thoracoscopic repair has recently been attempted in newborns with esophageal atresia (EA), but it remains unclear whether thoracoscopic dissection reduces pathological gastroesophageal reflux. We investigated the influence of a thoracoscopic approach on esophageal motor function in patients with EA.

Methods

Clinical and gastrointestinal data of 10 patients with EA with open repair (group A) and 7 with thoracoscopic repair (group B) were analyzed retrospectively. Videomanometry was conducted to investigate esophageal motor patterns. Esophageal acid exposure was evaluated with 24-hour esophageal pH monitoring. Data are expressed as medians and ranges.

Results

Contractions in the distal esophagus were conspicuously absent in 1 and 3 patients in groups A and B, respectively (P = .26). There were no significant differences in esophageal acid exposure (5.5 % [0.7 % -24.6 % ] vs 3.7 % [0.3 % -56.8 % ]; P = .71) or mean esophageal acid reflux time (0.5 minutes [0.1-1.4 minutes] vs 0.5 minutes [0.1-1.3 minutes]; P = .87) between the 2 groups. Fundoplication was conducted in 2 patients in each group (P = .60), all of whom had conspicuously absent distal esophageal contractions. Those contractions were preserved in the remaining patients with the exception of 1 group B patient.

Conclusion

There are unlikely to be benefits from thoracoscopic repair of EA in terms of postoperative esophageal motor function.