PURPUSE OF THE STUDY PROJECT: To validate the efficacy and safety of our modified surgical access, i.e. apical axillary mini-thoracotomy, for repair of esophageal atresia during the neonatal period.
METHODS: Single Institution, longitudinal and cross-sectional pilot study. Our prospectively-maintained database will be queried, starting from May 2011. The following parameters will be collected: patient demographics, occurrence of technical difficulties related to the use of our surgical approach, operative time, intra- and post-operative complications (with special emphasis on wound infection or break-down).
A detailed search for chest wall deformities, including scoliosis, winged scapula and hypoplasia of pectoralis major muscle will be performed. If unsatisfactory data will be available from our database, which includes also an imaging storage system, a special follow-up clinic will be arranged to assess shoulder function and musculoskeletal status, as well as evaluating the cosmetic appearance of the surgical scar. Finally, electromyography of the pectoralis major muscle will be performed in all new operated patients enrolled into the study.
Neonates receiving other type of thoracotomies for esophageal atresia repair will act as control.
HYPOTHESIS: Apical axillary mini-thoracotomy for repair of oesophageal atresia yields comparable technical success and potentially better outcomes to conventional thoracotomy.
As outlined in the previous sections, the aim of our study is to provide some evidence that the proposed apical axillary mini-thoracotomy for repair of oesophageal atresia yields comparable technical success and potentially better outcomes to conventional thoracotomy.
Better outcome measures of this less invasive approach to the thorax for the oesophageal atresia repair should include a lower incidence of chest deformity and an high overall satisfaction with the cosmetic outcome.
Results produced during the study project will be divulgated via publication in a peer-reviewed journal in the field of pediatric surgery. We hope that our scientific contributions will promote or facilitate take-up of our results by other health professionals involved in the care of these babies born with esophageal atresia.