الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
Esophageal atresia (EA) with or without a tracheo-esophageal (TEF) fistula is one of the rarer congenital anomalies occurring in one in 3,000 – 5000 live births. Conventionally, open, right-sided, muscle-sparing thoracotomy is the standard approach for repair of EA/TEF in many surgical centers, Thoracoscopy has been in use in pediatric surgery since the early 1990s. The first successful thoracoscopic repair of esophageal atresia was done in 1999. Since then several reports have shown the effectiveness and safety of thoracoscopic repair. The present work was a prospective case series was performed aiming at evaluating the feasibility and the short-term outcome of thoracoscopic repair of tracheoesophageal fistula with oesophageal atresia in neonates in Tanta university hospitals. A total of 19 neonates with oesophageal atresia and tracheoesophageal fistula admitted at Tanta University Hospitals over the period between July 2017 and July 2021 were included in the study. They all had thoracoscopic repair of the anomaly. Patients with major cardiac anomalies, severe prematurity and conversions to thoracotomy were excluded. There was male predominance in the enrolled series (1.71:1). Mean gestational age was 37.5 weeks. The mean weight was 2686 gm. A total of 84.2% of patients had cardiac anomalies with ASD, PHT and PDA being the commonest lesions. ENT anomalies were found in 3 patients. Renal anomalies were found in 2 patients. Hypospadias was found in 2 patients. Congenital inguinal hernias were found in 2 patients. Bucket-handle anomaly was found in 1 patient. Six cases had long gap requiring internal traction while 13 had immediate 1ry repair. The median age at operation of immediate 1ry repair was 5 days and the mean age was 6 days. The mean operative time for single stage repair was 90.4 minutes. The mean operative time for 1st setting of staged repair was 47 minutes minutes and for 2nd stage was 126.6 minutes with mean interval of 6 days between the 2 settings. Azygos vein was spared in all patients. Carinal fistula was found in 4 patients and all had internal traction and staged repair. No intraoperative complications occurred in any of the patients. Three patients had minor leak and 1 patient had major leak. Massive right lung collapse occurred in one patient, pneumonia and pneumothorax occurred in 3 patients but were not simultaneous, four patients had pneumonia only and three patients developed pneumothorax only. Mean post-operative hospital stay was 34 days.