Respiratory morbidity and growth after open thoracotomy or thoracoscopic repair of esophageal atresia

Abstract

Background: Respiratory morbidity has been described in patients who underwent repair of esophageal atresia as a neonate. We compared the influence of open thoracotomy or thoracoscopy on lung function, respiratory symptoms, and growth.

Methods: Functional residual capacity (FRC(p)), indicative of lung volume, and maximal expiratory flow at functional residual capacity (V'max(FRC)), indicative of airway patency, of 37 infants operated for esophageal atresia were measured with Masterscreen Babybody at 6 and 12 months. SD scores were calculated for V'max(FRC).

Results: Repair was by thoracotomy in 21 cases (57%) and by thoracoscopy in 16 cases (43%). Lung function parameters did not differ between the types of surgery (FRC(p); P = .384 and V'max(FRC); P = .241). FRC(p) values were in the upper normal range and increased from 6 to 12 months (22.5 and 25.4 mL/kg respectively, P = .010). Mean (SD) V'max(FRC) was below the norm without significant change in SD scores from 6 to 12 months (-1.9 and -2.3, respectively, P = .248). Neither lung function nor type of repair was associated with clinical evolution up to 2 years.

Conclusion: Lung function during the first year was similar in EA infants repaired by thoracotomy or thoracoscopy. Ongoing follow-up including pulmonary function testing is needed to determine whether differences occur at a later age in this cohort.