Atresia of the esophagus - thoracotomy vs thoracoscopy

Robert Chudzik, Katarzyna Jarosz-Chudzik, Maria Gołębiowska, Marcin Kulczyński, Małgorzata Pucułek


Esophageal atresia is a congenital medical condition associated with the disorder of the alimentary tract. It is usually associated with one or more fistulas to the trachea. Esophageal atresia is often associated with other congenital defects. The most frequent anomalies with atresia of the esophagus are those that occur in the VACTERL association. The incidence of oesophageal atresia mention in the literature varies 0.7-4.55/10000, because of the different percentage of defects other than esophageal atresia and associated with esophageal atresia changes. The etiology of esophageal atresia is mainly unknown, but it is considered multifactorial, including genetic and environmental factors. Indeed, 6-10% of cases of esophageal atresia have been diagnosed with a chromosomal abnormality or syndrome.
For the purpose of this study, we analyzed the current papers on esophageal atresia found in the PubMed database.
Traditionally, the esophageal atresia has been operated by the right posterior thoracotomy. The first thoracoscopic repair of classic esophageal atresia was performed in 1999, and the first successful thoracoscopy of the tracheo-oesophageal fistula a year later. Together with these milestones, numerous health centers have begun adapting this surgical technique. Although thoracoscopic surgery in the case of esophageal atresia in patients with tracheo-bronchial fistula was conducted in many highly developed children's surgery centers, the safety and efficacy of this method remained controversial. The benefits of thoracoscopic surgery are obvious, including excellent visualization, less use of post-operative drugs and cosmetic effects. Jaureguiza et al. described the "scaly scapula", chest wall deformity, scoliosis and the development of the bad nipple in patients who underwent open surgery due to esophageal atresia with the accompanying tacha-oesophageal fistula. In the case of open thoracotomy, it was necessary to withdraw the lungs to expose the posterior mediastinum, resulting in lung damage and respiratory complications.
Compared to the open surgery, thoracoscopy significantly reduced the time of hospital stay and the moment of the first oral meal. However, thoracoscopy was associated with a longer time of surgery. The incidence of leaks, narrowings, pulmonary complications, and blood loss were similar in both surgical technique. It seems that the benefits of thoracoscopy are significant.


Esophageal atresia, thoracoscopy, thoracotomy

Full Text:



Stoll C, Alembik Y, Dott B, Roth MP. Associated anomalies in cases with esophageal atresia. Am J Med Genet A. 2017 Aug;173(8):2139-2157. doi: 10.1002/ajmg.a.38303. Epub 2017 Jun 3. PubMed PMID: 28577344.

Abou Chaar MK, Meyers ML, Tucker BD, Galan HL, Liechty KW, Crombleholme TM,Marwan AI. Twin pregnancy complicated by esophageal atresia, duodenal atresia, gastric perforation, and hypoplastic left heart structures in one twin: a case report and review of the literature. J Med Case Rep. 2017 Mar 18;11(1):64. doi:10.1186/s13256-016-1195-x. Review. PubMed PMID: 28314387; PubMed Central PMCID: PMC5357333.

Gross R.E.: The surgery of infancy and chilhood. Philadelphia: WB Saunders, 1953.

White A, Bueno R. Long-Term Management Challenges in Esophageal Atresia. Curr Treat Options Gastroenterol. 2017 Mar;15(1):46-52. doi: 10.1007/s11938-017-0127-1. Review. PubMed PMID: 28120278.

Anna Rozensztrauch, Robert Śmigiel, Dariusz Patkowski. Pielęgnacja noworodka z zarośnięciem przełyku. Problemy Pielęgniarstwa 2015; 23 (2): 251–258

Dorothy I Bulas, MD, Prenatal diagnosis of esophageal, gastrointestinal, and anorectal atresia ed. UpToDate. Waltham, MA: UpToDate Inc.

Spaggiari E, Faure G, Rousseau V, Sonigo P, Millischer-Bellaiche AE, Kermorvant-Duchemin E, Muller F, Czerkiewicz I, Ville Y, Salomon LJ. Performance of prenatal diagnosis in esophageal atresia. Prenat Diagn. 2015 Sep;35(9):888-93. doi: 10.1002/pd.4630. Epub 2015 Jul 6. PubMed PMID: 26058746.

Wu Y, Kuang H, Lv T, Wu C. Comparison of clinical outcomes between open and thoracoscopic repair for esophageal atresia with tracheoesophageal fistula: a systematic review and meta-analysis. Pediatr Surg Int. 2017 Nov;33(11):1147-1157. doi: 10.1007/s00383-017-4153-9. Epub 2017 Sep 15. PubMed PMID: 28914345.

Jaureguizar E, Vazquez J, Murcia J, Diez Pardo JA. Morbid musculoskeletal sequelae of thoracotomy for tracheoesophageal fistula. J Pediatr Surg. 1985 Oct;20(5):511-4. PubMed PMID: 4057018.

Koga H, Yamoto M, Okazaki T, Okawada M, Doi T, Miyano G, Fukumoto K, Lane GJ, Urushihara N, Yamataka A. Factors affecting postoperative respiratory tract function in type-C esophageal atresia. Thoracoscopic versus open repair. Pediatr Surg Int. 2014 Dec;30(12):1273-7. doi: 10.1007/s00383-014-3618-3. Epub 2014 Oct 16. PubMed PMID: 25319797.

Holcomb, G.W. Thoracoscopic surgery for esophageal atresia Pediatr Surg Int (2017) 33: 475.

Nomura A, Yamoto M, Fukumoto K, Takahashi T, Ohyama K, Sekioka A, Yamada Y,Urushihara N. Evaluation of developmental prognosis for esophageal atresia with tracheoesophageal fistula. Pediatr Surg Int. 2017 Aug 12. doi:10.1007/s00383-017-4142-z. [Epub ahead of print] PubMed PMID: 28803355.

Svoboda E, Fruithof J, Widenmann-Grolig A, Slater G, Armand F, Warner B, Eaton S, De Coppi P, Hannon E. A patient led, international study of long term outcomes of esophageal atresia: EAT 1. J Pediatr Surg. 2017 Jun 9. pii: S0022-3468(17)30352-4. doi: 10.1016/j.jpedsurg.2017.05.033. [Epub ahead of print]PubMed PMID: 28622972.

Gibreel W, Zendejas B, Antiel RM, Fasen G, Moir CR, Zarroug AE. Swallowing Dysfunction and Quality of Life in Adults With Surgically Corrected Esophageal Atresia/Tracheoesophageal Fistula as Infants: Forty Years of Follow-up. Ann Surg. 2017 Aug;266(2):305-310. doi: 10.1097/SLA.0000000000001978. PubMed PMID: 27607100.



  • There are currently no refbacks.

Copyright (c) 2018 © The Author(s)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Journal of Education, Health and Sport formerly Journal of Health Sciences

Declaration on the original version.

Editors indicates that the main version of the magazine is to issue a "electronic".

The journal has had 5 points in Ministry of Science and Higher Education parametric evaluation. § 8. 2) and § 12. 1. 2) 22.02.2019.

1223 Journal of Education, Health and Sport eISSN 2391-8306 7

ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

Archives 2011 - 2014

PBN 2011 - 2014

POL-index 2011 - 2014

BASE 2011 - 2014

Indexed in Bases, Bazy indeksacyjne: ERIH Plus, Worldcat, PBN/POL-Index, ICI Journals Master List, Directory of Open Access Journals (DOAJ), ZBD, Ulrich's periodicals, Google Scholar, Polska Bibliografia Lekarska

US NLM = 101679844

101679844 - NLM Catalog Result - NCBI

Find a library that holds this journal:

Journal Language(s): English 

PBN Poland



Redaction, Publisher and Editorial Office

Instytut Kultury Fizycznej Uniwersytet Kazimierza Wielkiego w Bydgoszczy, Institute of Physical Education Kazimierz Wielki University in Bydgoszcz, Poland 85-091 Bydgoszcz ul. Sportowa 2 Copyright by Instytut Kultury Fizycznej UKW w Bydgoszczy  Open Access ISSN 2391-8306 formerly ISSN: 1429-9623 / 2300-665X

The journal has been approved for inclusion in ERIH PLUS.

The ERIH PLUS listing of the journal is available at

SIC Science citation index (calculated on the basis of TCI and Page Rank) 0

Russian Impact factor 0.16

Indexed in Index Copernicus Journals Master List.,p24782242,3.html

ICV 2018 = 95.95 ICV 2017 = 91.30 ICV 2016 = 84.69 ICV 2015 = 93.34 ICV 2014 = 89.51 Standardized Value: 8.27 ICV 2013: 7.32 ICV 2012: 6.41 ICV 20115.48

The InfoBase Index IBI Factor for the year 2015 is 3.56 in InfoBase


Universal Impact Factor 1.78 for year 2012. (

Indexed in Polish Scholarly Bibliography (PBN) (PBN Polska Bibliografia Naukowa) (

is a portal of the Polish Ministry of Science and Higher Education, collecting information on publications of Polish scientists and on Polish and foreign scholarly journals. Polish Scholarly Bibliograhpy is a part of POL-on - System of Information on Higher Education. It is operated by the Interdisciplinary Centre for Mathematical and Computational Modelling, University of Warsaw.

Indexed in Russian Sciences Index Российский индекс научного цитирования (РИНЦ)

Indexed in Arianta Polish scientific and professional electronic journals Aneta Drabek i Arkadiusz Pulikowski