Open AccessLeft thoracoscopic two-stage repair of tracheoesophageal fistula with a right aortic arch and a vascular ring
Author(s) -
Koichiro Oshima,
Hiroo Uchida,
Takahisa Tainaka,
Akihide Tanano,
Chiyoe Shirota,
Kazuki Yokota,
Naruhiko Murase,
Ryo Shirotsuki,
Kosuke Chiba,
Akinari Hinoki
Publication year - 2017
Publication title -
journal of minimal access surgery
Language(s) - English
Resource type - Journals
eISSN - 0972-9941
pISSN - 1998-3921
DOI - 10.4103/0972-9941.181771
Subject(s) - medicine , vascular ring , thoracoscope , surgery , thoracoscopy , ductus arteriosus , vascular surgery , pouch , fistula , aortic arch , tracheoesophageal fistula , stage (stratigraphy) , dissection (medical) , aorta , cardiac surgery , biology , paleontology
A right aortic arch (RAA) is found in 5% of neonates with tracheoesophageal fistulae (TEF) and may be associated with vascular rings. Oesophageal repairs for TEF with an RAA via the right chest often pose surgical difficulties. We report for the first time in the world a successful two-stage repair by left-sided thoracoscope for TEF with an RAA and a vascular ring. We switched from right to left thoracoscopy after finding an RAA. A proximal oesophageal pouch was hemmed into the vascular ring; therefore, we selected a two-stage repair. The TEF was resected and simple internal traction was placed into the oesophagus at the first stage. Detailed examination showed the patent ductus arteriosus (PDA) completing a vascular ring. The subsequent primary oesophago-oesophagostomy and dissection of PDA was performed by left-sided thoracoscope. Therefore, left thoracoscopic repair is safe and feasible for treating TEF with an RAA and a vascular ring.