{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T18:16:16Z","timestamp":1773166576619,"version":"3.50.1"},"reference-count":23,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Recurrent tracheoesophageal fistula (RTEF) is usually a consequence of leakage or other complications after esophageal atresia repair performed through right-sided access. This results in extensive intrapleural adhesions, and open redo surgery poses a challenge. Alternatively, endoscopic endotracheal fistula obliteration usually requires repetitive procedures, and its success rate varies significantly between centers. We present a novel approach to recurrent fistulas. The innovation is in reaching the fistula through the virgin field via left-sided three-port thoracoscopy instead of classical right-sided thoracotomy. Methods: This is a presentation of a new operative technique based on a retrospective case series of patients operated on at our department between 2016 and 2023. Results: Eight patients after esophageal atresia repair (six with RTEF and two with post-fistula tracheal diverticula) were successfully treated with left-sided thoracoscopy. There were no conversions. One patient required rethoracoscopy for chylothorax. Another one, after RTEF closure, underwent multiple endoscopic obliterations of subsequent tracheal diverticulum. No other major complications nor re-recurrences were noted. Conclusions: Left-sided thoracoscopy in redo esophageal atresia has the advantage of a \u201cvirgin\u201d operative field and grants feasible access to the RTEF or tracheal diverticulum. We believe that this approach is worth further exploration because it combines minimal invasiveness with high effectiveness without all the consequences of a thoracotomy.<\/jats:p>","DOI":"10.3390\/jcm12237251","type":"journal-article","created":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T03:45:56Z","timestamp":1700711156000},"page":"7251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Novel Left-Sided Thoracoscopic Approach to Recurrent Tracheoesophageal Fistula and Post-Fistula Tracheal Diverticula"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4583-5517","authenticated-orcid":false,"given":"Dariusz","family":"Patkowski","sequence":"first","affiliation":[{"name":"Clinical Department of Pediatric Surgery and Urology, Wroc\u0142aw Medical University, Borowska 213, 50-556 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4336-2151","authenticated-orcid":false,"given":"Krystian","family":"Toczewski","sequence":"additional","affiliation":[{"name":"Clinical Department of Pediatric Surgery and Urology, Wroc\u0142aw Medical University, Borowska 213, 50-556 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ergun","family":"Ergun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Faculty of Medicine, Ankara University, A\u00dc T\u0131p Fak\u00fcltesi Hst. No: 6, Ankara 06620, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1097\/MOO.0000000000000315","article-title":"Tracheoesophageal Fistula: Open versus Endoscopic Repair","volume":"24","author":"Daniel","year":"2016","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/j.jpedsurg.2014.11.004","article-title":"Revisional Surgery for Recurrent Tracheoesophageal Fistula and Anastomotic Complications after Repair of Esophageal Atresia in 258 Infants","volume":"50","author":"Koivusalo","year":"2015","journal-title":"J. Pediatr. 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Endosc."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7251\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:28:04Z","timestamp":1760131684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7251"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,23]]},"references-count":23,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jcm12237251"],"URL":"https:\/\/doi.org\/10.3390\/jcm12237251","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,23]]}}}