{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T04:08:29Z","timestamp":1793506109621,"version":"4.5.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T00:00:00Z","timestamp":1612656000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,2,7]],"date-time":"2021-02-07T00:00:00Z","timestamp":1612656000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Thoracoscopic OA\/TOF repair was first described in 1999. Currently, less than 10% of surgeons routinely employ minimally access surgery. Our primary aim was to review our immediate-, early- and long-term outcomes with this technique compared with the open approach.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A retrospective review of all patients undergoing primary OA\/TOF (Type C) repair at our institution from 2009 was conducted. Outcome measures included length of surgery, conversion rate from thoracoscopy, early complications such as anastomotic leak and post-operative complications such as anastomotic strictures needing dilatations. Fisher\u2019s exact and Kruskal\u2013Wallis tests were used for statistical analysis.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>95 patients in total underwent OA\/TOF repair during the study period of which 61 (64%) were completed via an open approach. 34 were attempted thoracoscopically of which 11 (33%) were converted. There was only one clinically significant anastomotic leak in our series that took place in the thoracoscopic group. We identified a significantly higher stricture rate in our thoracoscopic cohort (72%) versus open surgery (43%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). However, the median number of dilations (3) performed was not significantly different between the groups. There was one recurrent fistula in the thoracoscopic converted to open group. Our median follow-up was 60\u00a0months across the groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>In our experience, the clinically significant leak rate for both open and thoracoscopic repair as well as recurrent fistula is much lower than has been reported in the literature. We do not routinely perform contrast studies and are, thus, reporting clinically significant leaks only. The use of post-operative neck flexion, ventilation and paralysis is likely to be protective towards a leak. Thoracoscopic OA\/TOF repair is associated with a higher stricture rate compared with open surgery; however, these strictures respond to a similar number of dilatations and are no more refractory. Larger, multicentre studies may be useful to investigate these finding further.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00383-020-04829-3","type":"journal-article","created":{"date-parts":[[2021,2,9]],"date-time":"2021-02-09T03:13:01Z","timestamp":1612840381000},"page":"397-401","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Thoracoscopic oesophageal atresia\/tracheo-oesophageal fistula (OA\/TOF) repair is associated with a higher stricture rate: a single institution\u2019s experience"],"prefix":"10.1007","volume":"37","author":[{"given":"H.","family":"Thakkar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. M.","family":"Mullassery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Giuliani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Blackburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Cross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Curry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"De Coppi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,2,7]]},"reference":[{"key":"4829_CR1","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1089\/pei.1999.3.141","volume":"3","author":"TE Lobe","year":"1999","unstructured":"Lobe TE, Rothenberg S, Waldschmidt J et al (1999) Thoracoscopic repair of esophageal atresia in an infant: a surgical first. Pediatr Endosurg Innov Tech 3:141\u2013148","journal-title":"Pediatr Endosurg Innov Tech"},{"issue":"30","key":"4829_CR2","doi-asserted-by":"publisher","first-page":"e4428","DOI":"10.1097\/MD.0000000000004428","volume":"95","author":"YF Yang","year":"2016","unstructured":"Yang YF, Dong R, Zheng C, Jin Z, Chen G, Huang YL, Zheng S (2016) Outcomes of thoracoscopy versus thoracotomy for esophageal atresia with tracheoesophageal fistula repair: a PRISMA-compliant systematic review and meta-analysis. Medicine 95(30):e4428","journal-title":"Medicine"},{"issue":"4","key":"4829_CR3","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1016\/j.jpedsurg.2017.05.033","volume":"53","author":"E Svoboda","year":"2018","unstructured":"Svoboda E, Fruithof J, Widenmann-Grolig A, Slater G, Armand F, Warner B, Eaton S, De Coppi P, Hannon E (2018) A patient led, international study of long term outcomes of esophageal atresia: EAT 1. J Pediatr Surg 53(4):610\u2013615","journal-title":"J Pediatr Surg"},{"issue":"1","key":"4829_CR4","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1055\/s-0033-1350058","volume":"24","author":"A Zani","year":"2014","unstructured":"Zani A, Eaton S, Hoellwarth ME, Puri P, Tovar J, Fasching G, Bagolan P, Lukac M, Wijnen R, Kuebler JF, Cecchetto G, Rintala R, Pierro A (2014) International survey on the management of esophageal atresia. Eur J Pediatr Surg 24(1):3\u20138","journal-title":"Eur J Pediatr Surg"},{"issue":"10","key":"4829_CR5","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1016\/j.jpedsurg.2006.07.004","volume":"41","author":"L Spitz","year":"2006","unstructured":"Spitz L (2006) Esophageal atresia. Lessons I have learned in a 40-year experience. J Pediatr Surg 41(10):1635\u20131640","journal-title":"J Pediatr Surg"},{"issue":"9","key":"4829_CR6","doi-asserted-by":"publisher","first-page":"1343","DOI":"10.1016\/j.jpedsurg.2014.03.021","volume":"49","author":"HS Thakkar","year":"2014","unstructured":"Thakkar HS, Cooney J, Kumar N, Kiely E (2014) Measured gap length and outcomes in oesophageal atresia. J Pediatr Surg 49(9):1343\u20131346","journal-title":"J Pediatr Surg"},{"issue":"2","key":"4829_CR7","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.jpedsurg.2005.11.009","volume":"41","author":"PJ Lopez","year":"2006","unstructured":"Lopez PJ, Keys C, Pierro A, Drake DP, Kiely EM, Curry JI, Spitz L (2006) Oesophageal atresia: improved outcome in high-risk groups? J Pediatr Surg 41(2):331\u2013334","journal-title":"J Pediatr Surg"},{"issue":"1","key":"4829_CR8","first-page":"14","volume":"23","author":"C Dingemann","year":"2013","unstructured":"Dingemann C, Zoeller C, Ure B (2013) Thoracoscopic repair of oesophageal atresia: results of a selective approach. Eur J Pediatr Surg 23(1):14\u201318","journal-title":"Eur J Pediatr Surg"},{"issue":"9","key":"4829_CR9","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1007\/s00595-019-01884-9","volume":"50","author":"H Okuyama","year":"2020","unstructured":"Okuyama H, Saka R, Takama Y, Nomura M, Ueno T, Tazuke Y (2020) Thoracoscopic repair of esophageal atresia. Surg Today 50(9):966\u2013973","journal-title":"Surg Today"},{"issue":"6","key":"4829_CR10","doi-asserted-by":"publisher","first-page":"895","DOI":"10.1097\/SLA.0b013e31828fab55","volume":"258","author":"M Bishay","year":"2013","unstructured":"Bishay M, Giacomello L, Retrosi G, Thyoka M, Garriboli M, Brierley J, Harding L, Scuplak S, Cross KM, Curry JI, Kiely EM, De Coppi P, Eaton S, Pierro A (2013) Hypercapnia and acidosis during open and thoracoscopic repair of congenital diaphragmatic hernia and esophageal atresia: results of a pilot randomized controlled trial. Ann Surg 258(6):895\u2013900","journal-title":"Ann Surg"},{"issue":"7","key":"4829_CR11","doi-asserted-by":"publisher","first-page":"1356","DOI":"10.1016\/j.jpedsurg.2019.11.026","volume":"55","author":"M Sidler","year":"2020","unstructured":"Sidler M, Wong ZH, Eaton S, Ahmad N, Ong M, Morsi A, Rees CM, Giuliani S, Blackburn S, Curry JI, Cross KM, De Coppi P (2020) J Pediatr Surg 55(7):1356\u20131362","journal-title":"J Pediatr Surg"},{"issue":"1","key":"4829_CR12","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1007\/BF00173597","volume":"2","author":"GA Mackinlay","year":"1987","unstructured":"Mackinlay GA, Burtles R (1987) Oesophageal atresia: paralysis and ventilation in management of the wide gap. Pediatr Surg Int 2(1):10\u201312","journal-title":"Pediatr Surg Int"},{"issue":"2\u20133","key":"4829_CR13","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s003830000457","volume":"17","author":"P Lyall","year":"2001","unstructured":"Lyall P, Bao-Quan Q, Beasley S (2001) The effect of neck flexion on oesophageal tension in the pig and its relevance to repaired oesophageal atresia. Pediatr Surg Int 17(2\u20133):193\u2013195","journal-title":"Pediatr Surg Int"},{"issue":"1","key":"4829_CR14","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1007\/s00383-018-4379-1","volume":"35","author":"JS O'Connell","year":"2019","unstructured":"O\u2019Connell JS, Janssen Lok M, Miyake H, Seo S, Bindi E, Alganabi M, Pierro A (2019) Post-operative paralysis and elective ventilation reduces anastomotic complications in esophageal atresia: a systematic review and meta-analysis. Pediatr Surg Int 35(1):87\u201395","journal-title":"Pediatr Surg Int"},{"issue":"8","key":"4829_CR15","doi-asserted-by":"publisher","first-page":"923","DOI":"10.1089\/lap.2020.0099","volume":"30","author":"M Guelfand","year":"2020","unstructured":"Guelfand M, Ferraris T, Godoy J (2020) Early management of esophageal leak in esophageal atresia: changing paradigms. J Laparoendosc Adv Surg Tech A 30(8):923\u2013926","journal-title":"J Laparoendosc Adv Surg Tech A"},{"issue":"1","key":"4829_CR16","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1055\/s-0038-1668150","volume":"29","author":"J Zimmer","year":"2019","unstructured":"Zimmer J, Eaton S, Murchison LE, De Coppi P, Ure BM, Dingemann C (2019) State of play: eight decades of surgery for esophageal atresia. Eur J Pediatr Surg Actions 29(1):39\u201348","journal-title":"Eur J Pediatr Surg Actions"},{"issue":"8","key":"4829_CR17","doi-asserted-by":"publisher","first-page":"e106149","DOI":"10.1371\/journal.pone.0106149","volume":"9","author":"B Allin","year":"2014","unstructured":"Allin B, Knight M, Johnson P, Burge D (2014) BAPSCASS Outcomes at one-year post anastomosis from a national cohort of infants with oesophageal atresia. PLoS ONE 9(8):e106149","journal-title":"PLoS ONE"},{"issue":"8","key":"4829_CR18","doi-asserted-by":"publisher","first-page":"898","DOI":"10.1007\/s00247-013-2693-2","volume":"43","author":"M Thyoka","year":"2013","unstructured":"Thyoka M, Timmis A, Mhango T, Roebuck D (2013) Balloon dilatation of anastomotic strictures secondary to surgical repair of oesophageal atresia: a systematic review. Pediatr Radiol 43(8):898\u2013901","journal-title":"Pediatr Radiol"},{"issue":"1","key":"4829_CR19","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1186\/s12887-018-1359-5","volume":"18","author":"C Wang","year":"2018","unstructured":"Wang C, Feng L, Li Y, Ji Y (2018) What is the impact of the use of transanastomotic feeding tube on patients with esophageal atresia: a systematic review and meta-analysis. BMC Pediatr 18(1):385","journal-title":"BMC Pediatr"},{"issue":"9","key":"4829_CR20","doi-asserted-by":"publisher","first-page":"2093","DOI":"10.1007\/s00268-012-1651-8","volume":"36","author":"DC van der Zee","year":"2012","unstructured":"van der Zee DC, Tytgat SH, Zwaveling S, van Herwaarden MY, Vieira-Travassos D (2012) Learning curve of thoracoscopic repair of esophageal atresia. World J Surg 36(9):2093\u20132097","journal-title":"World J Surg"},{"issue":"11","key":"4829_CR21","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1016\/j.jpedsurg.2014.04.016","volume":"49","author":"S Lee","year":"2014","unstructured":"Lee S, Lee SK, Seo JM (2014) Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula: overcoming the learning curve. J Pediatr Surg 49(11):1570\u20131572","journal-title":"J Pediatr Surg"},{"issue":"4","key":"4829_CR22","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1055\/s-0039-1693116","volume":"30","author":"C Dingemann","year":"2020","unstructured":"Dingemann C, Eaton S, Aksnes G, Bagolan P, Cross KM, De Coppi P, Fruitfof J, Gamba P, Husby S, Koivusalo A, Rasmussen L, Sfeir R, Slater G, Svensson JF, Van der Zee DC, Wessel LM, Widenmann-Grolig A, Wijnen R, Ure BM (2020) ERNICA consensus conference on the management of patients with esophageal atresia and tracheoesophageal fistula: diagnostics, preoperative, operative, and postoperative management. Eur J Pediatr Surg 30(4):326\u2013336","journal-title":"Eur J Pediatr Surg"},{"issue":"11","key":"4829_CR23","doi-asserted-by":"publisher","first-page":"1167","DOI":"10.1007\/s00383-019-04527-9","volume":"35","author":"C Way","year":"2019","unstructured":"Way C, Wayne C, Grandpierre V, Harrison BJ, Travis N, Nasr A, Way C et al (2019) Thoracoscopy vs. thoracotomy for the repair of esophageal atresia and tracheoesophageal fistula: a systematic review and meta-analysis. Pediatr Surg Int 35(11):1167\u20131184","journal-title":"Pediatr Surg Int"},{"issue":"9","key":"4829_CR24","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1007\/s00383-014-3554-2","volume":"30","author":"M Yamoto","year":"2014","unstructured":"Yamoto M, Urusihara N, Fukumoto K et al (2014) Thoracoscopic versus open repair of esophageal atresia with tracheoesophageal fistula at a single institution. Pediatr Surg Int 30(9):883\u2013887","journal-title":"Pediatr Surg Int"},{"issue":"2","key":"4829_CR25","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1136\/archdischild-2017-314710","volume":"104","author":"FWT Vergouwe","year":"2019","unstructured":"Vergouwe FWT, Vlot J, IJsselstijn H, on behalf of the DCEA Study Group et al (2019) Risk factors for refractory anastomotic strictures after oesophageal atresia repair: a multicentre study. Arch Dis Child 104(2):152\u2013157","journal-title":"Arch Dis Child"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-020-04829-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00383-020-04829-3\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-020-04829-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,2,22]],"date-time":"2021-02-22T18:10:11Z","timestamp":1614017411000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00383-020-04829-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,7]]},"references-count":25,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["4829"],"URL":"https:\/\/doi.org\/10.1007\/s00383-020-04829-3","relation":{},"ISSN":["0179-0358","1437-9813"],"issn-type":[{"value":"0179-0358","type":"print"},{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,7]]},"assertion":[{"value":"30 November 2020","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 February 2021","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}