Prevention and treatment strategies for esophageal stenosis after thoracoscopy for type Ⅲ esophageal atresia北大核心CSCD

Objective To explore the roles of esophageal stenosis control strategies in children with esophageal atresia (EA). Methods Retrospective analysis was conducted for clinical data of 56 children with type Ⅲ EA undergoing thoracoscopy from January 2017 to December 2022.There were 30 boys and 26 girls.The clinical types were ⅢA (n=12) and ⅢB (n=11) in group A. Birth weight was (2573.26±112.77) gram and operative age (31.70±5.86) hours.Eight cases had concurrent congenital heart disease (CHD). And 33 patients received traditional postoperative observation (group B). The clinical types were ⅢA (n=18) and ⅢB (n=15) in group B. Birth weight was (2 598.79±94.88) gram and operative age (37.00±7.15) hour.Six cases had concurrent CHD.Preoperative profiles and postoperative recovery of two groups were compared along with differential efficacy between the prevention and treatment strategy after comparing EA and traditional management mode. Results No statistically significant inter-group differences existed in operative age (P=0.593), body weight (P=0.863) or proportion of CHD (P=0.438). One-stage surgery was performed for repairing tracheoesophageal fistula and esophageal reconstruction.Later they were cured and discharged with regular follow-ups.The incidence of postoperative anastomotic stenosis was 26.09%(6/23) in group A versus 60.61%(20/33) in group B. The inter-group difference was insignificant (P=0.125). There were 0 cases (0%) of anastomotic leakage in group A versus 3 cases in group B (9.09%)(P=0.001). Average dilation frequency was(0.61±0.27) vs (2.00±0.41), P=0.014]and incidence of postoperative refractory stenosis0(0%) vs 4(12.12%), P=0.001]. The differences were statistically significant. Conclusions Perioperative comprehensive management plays some roles in the prevention and treatment of esophageal stricture after EA thoracoscopy.The clinical outcomes are satisfactory. © 2023 Chinese Medical Journals Publishing House Co.Ltd.. All rights reserved.