先天性C型食道閉鎖に対する胸腔鏡下根治手術

Thoracoscopic repair of esophageal atresia with tracheoesophageal fistula

◆要旨：新生児の先天性C型食道閉鎖に対する胸腔鏡下食道閉鎖根治術について報告した．【対象】生後1～7日，体重1,212～3,140gの7例に胸腔鏡下手術を施行した．【結果】7例中6例で胸腔鏡下根治術，極低出生体重児1例では食道吻合は困難で瘻孔閉鎖術のみを行なった．根治術の手術時間は150～260分（平均201分）．術後7日の造影で2例にリークが見られたが保存的治療で軽快した．全例経過は順調である．【結語】美容面でも優れており，従来の術式に代わる優れた術式になると考えられた．

　Seven neonates with esophageal atresia and tracheoesophageal fistula（EA/TEF）underwent repair thoracoscopically. Weights ranged from 1,212 to 3,140 g. Six of 7 patients underwent a successful thoracoscopic repair, and one patient weighing 1,212 g underwent TEF ligation without esophageal anastomosis. The mean operation time was 201 minutes（range, 150 to 260）. Two patients had a postoperative leak that healed on conservative treatment. A cosmetic result was excellent, and all patients were asymptomatic. In conclusion, thoracoscopic repair of EA/TEF is feasible, and may be an attractive treatment option.