{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T12:59:36Z","timestamp":1762001976298,"version":"3.37.3"},"reference-count":4,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"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":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Repair of esophageal atresia is usually performed through the right thoracic cavity. However, when the upper pouch of the esophagus and tracheoesophageal fistula (TEF) is located in the thoracic inlet and completely on the left side of trachea, it is difficult to dissect and anastomose the esophagus through the right thoracic cavity. We present a case of esophageal atresia, with the esophageal upper pouch located high and completely on the left side of trachea, successfully repaired via the median sternotomy approach.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A male neonate with a birth weight of 1766\u00a0g was prematurely delivered via cesarean section at 34\u00a0weeks of gestation. Contrast-enhanced computed tomography (CT) showed that the upper pouch of the esophagus was located at the thoracic inlet and completely on the left side of the trachea; hence, a diagnosis of esophageal atresia was made. Moreover, a TEF was connected to the trachea at the level of the lower end of the upper esophageal pouch. An aberrant right subclavian artery and persistent left superior vena cava were also detected. Esophageal dissection and anastomosis were determined to be very difficult if approached from the right thoracic cavity. Therefore, we performed median sternotomy one day after the neonate was born. The upper pouch of the esophagus and TEF were easily dissected via the median sternotomy approach. Anastomosis of the esophagus was performed, with a good visual field, to the left of the trachea. The postoperative course was uneventful.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>This is the first reported case of a median sternotomy approach for esophageal atresia. This technique may be useful when a right thoracic approach is difficult, especially if the esophageal upper pouch is located completely to the left of the trachea or if it is higher than the normal position.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-022-01523-5","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T21:05:33Z","timestamp":1662671133000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Median sternotomy approach for the repair of esophageal atresia: a case report"],"prefix":"10.1186","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2981-7148","authenticated-orcid":false,"given":"Hiroaki","family":"Fukuzawa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsumasa","family":"Okamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yudai","family":"Tsuruno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayako","family":"Maruo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"1523_CR1","first-page":"352","volume-title":"pediatric surgery","author":"S Lewis","year":"2005","unstructured":"Lewis S. Esophageal atresia and Tracheoesophageal Malformations. In: Ashcraft KW, Holcomb GW, Murphy JP, editors. pediatric surgery. 4th ed. Philadelphia: Elsevier Saunders; 2005. p. 352\u201365.","edition":"4"},{"key":"1523_CR2","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1016\/0022-3468(95)90128-0","volume":"30","author":"H Kemmotsu","year":"1995","unstructured":"Kemmotsu H, Joe K, Nakamura H, Yamashita M. Cervical approach for the repair of esophageal atresia. J Pediatr Surg. 1995;30:549\u201352. https:\/\/doi.org\/10.1016\/0022-3468(95)90128-0.","journal-title":"J Pediatr Surg"},{"key":"1523_CR3","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.2214\/ajr.175.5.1751403","volume":"175","author":"S Fitoz","year":"2000","unstructured":"Fitoz S, Atasoy C, Yagmurlu A, Akyar S, Erden A, Dindar H. Three-dimensional CT of congenital esophageal atresia and distal tracheoesophageal fistula in neonates: preliminary results. AJR Am J Roentgenol. 2000;175:1403\u20137. https:\/\/doi.org\/10.2214\/ajr.175.5.1751403.","journal-title":"AJR Am J Roentgenol"},{"key":"1523_CR4","doi-asserted-by":"publisher","first-page":"1966","DOI":"10.1016\/j.jpedsurg.2013.06.010","volume":"48","author":"S Garge","year":"2013","unstructured":"Garge S, Rao KL, Bawa M. The role of preoperative CT scan in patients with tracheoesophageal fistula: a review. J Pediatr Surg. 2013;48:1966\u201371. https:\/\/doi.org\/10.1016\/j.jpedsurg.2013.06.010.","journal-title":"J Pediatr Surg"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01523-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-022-01523-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-022-01523-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T21:06:10Z","timestamp":1662671170000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-022-01523-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,8]]},"references-count":4,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1523"],"URL":"https:\/\/doi.org\/10.1186\/s40792-022-01523-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"type":"electronic","value":"2198-7793"}],"subject":[],"published":{"date-parts":[[2022,9,8]]},"assertion":[{"value":"14 July 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 September 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The report was approved by our institutional ethics committee (2022-06).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the family of the patient for publication of this case report.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"165"}}