Clinical Effect Analysis Of Thoracoscopic Surgery For Esophageal Atresia Type ?

Objective: To investigate the safety,reliability and clinical effect of minimally invasive thoracoscopic treatment of type ? esophageal atresia,the clinical data of traditional transthoracic surgery and thoracoscopic primary esophageal atresia were compared and analyzed statistically.Methods: Retrospective analysis was performed on 92 cases of children with type ? esophageal atresia treated in our hospital from January 2015 to December 2018.All the children had obvious clinical symptoms,including excessive amniotic fluid during pregnancy,postpartum nasal and oral foamy,paroxysmal cough,shortness of breath,temporary cyanosis,and gastric tube implantation when gastric tube was indwelling,etc.The diagnosis of type ? esophageal atresia was confirmed by combining esophagography and three-dimensional reconstruction of chest CT.According to the different surgical methods,the patients were divided into group A,A total of 49 cases of children with stage I thoracoscopic esophageal atresia;In group B,43 children with type ? esophageal atresia were treated by conventional thoracotomy.General data,operation time,mechanical ventilation time,monitoring time,drainage volume of pleural fluid,blood transfusion volume,gastric tube removal time,postoperative hospitalization time,incision length,hospitalization cost,postoperative complications,postoperative follow-up and other clinical data of the two groups were collected,and the clinical data of the two groups were statistically analyzed.Results: The operation was successful in both groups,and no children in the two groups were transferred to thoracotomy for thoracoscopic surgery.There was no statistically significant difference in preoperative data between the two groups(P>0.05).But in postoperative mechanical ventilation time monitoring postoperative hospital stay chest water flow quantity of blood transfusion incision length,etc,is better than that of group B,group A statistically significant difference(P < 0.05)in the postoperative complications: A group of children with severe pneumonia infection of incision,postoperative complications such as chest wall deformity rate lower than group B,the difference was statistically significant(P < 0.05);The incidence of death of pneumothorax trachomalacia anastomotic fistula and anastomotic stenosis was not statistically significant in the two groups(P>0.05).The incidence of trachomalacia gastroesophageal reflux was not statistically significant in the two groups after surgery and during the early follow-up(P>0.05),and no complications such as cardiac achalasia and esophageal diverticulum occurred in the two groups during the early follow-up.Conclusion: Primary thoracoscopic ? esophageal atresia has the same safety,feasibility and clinical efficacy as traditional thoracotomy primary thoracoscopic ? esophageal atresia.Its advantage lies in the clear and rapid recovery of minimally invasive surgical field of vision,which is a new trend in the treatment of ? esophageal atresia.