Comparison Of Extrapleural And Transpleural Approach In The Treatment Of Type ? Congenital Esophageal Atresia

Objective: To compare the efficacy of extrapleural and transpleural approach in the treatment of type ? congenital esophageal atresia.Methods:A retrospective analysis was performed on 42 cases of type ? congenital esophageal atresia who were operated in our hospital from January 2017 to September 2018,including 21 males and 21 females.Among them,17 patients were operated via extrapleural approach while 25 patients were operated via transpleural approach.Results:All the 42 patients were operated successfully,40 patients were cured and discharged,2 patients died due to complications.There was no significant difference in the operation time between two approaches(96.00±7.73 min vs 93.64±4.47 min,P=0.924).There was significant difference in the Postoperative ventilator using time and postoperative hospitalization time between two approaches(3.91±2.13 days vs 6.44±4.17 days,P=0.036;20.53±4.16 days vs 26.05±9.07 days,P=0.036).6 cases of pulmonary complications and 2 cases of anastomotic leakage were found with the extrapleural operation group,and 15 cases of pulmonary complications and 7 cases of anastomotic leakage were found with the transpleural operation group,however,there no significant difference between two groups(P=0.116;P=0.381).Conclusions : The treatment of type ? esophageal atresia via extrapleural approach is less invasive to lung,more smooth recovery and outcomes,the extrapleural approach should be considered prior in the open surgery.