• Alexis P Arnaud, Dean Rex, Martin J Elliott, Joe Curry, Edward Kiely, Agostino Pierro, Kate Cross, and Paolo De Coppi.
• 1 General Paediatric Surgery Department, Great Ormond Street Hospital , NHS Foundation Trust, London, United Kingdom .
• J Laparoendosc Adv Surg Tech A. 2014 Jul 1; 24 (7): 508-12.

BackgroundAortopexy is the most effective treatment for severe tracheomalacia associated with esophageal atresia with distal tracheo-esophageal fistula (EA/TOF). In the last few years, the thoracoscopic approach has been proposed, but the number of patients treated is limited. The purpose of this study is to review our initial experience with thoracoscopic aortopexy.Patients And MethodsA retrospective review of medical records was performed on EA/TOF patients undergoing thoracoscopic aortopexy at the Great Ormond Street Hospital for Sick Children (London, United Kingdom) from January 2009 to May 2012. Patient demographics, indication, perioperative course, and long-term results when available were noted.ResultsFour patients underwent a successful thoracoscopic aortopexy, with no operation being converted. No morbidity or mortality was associated with the procedure. Length of postoperative stay ranged from 2 to 4 days. All patients were relieved of their symptoms, and no recurrence was noted.ConclusionsThoracoscopic aortopexy is a feasible and successful treatment for severe tracheomalacia in EA/TOF patients. The complication rate may be lower than after the open procedure and is more satisfactory in terms of cosmetic appearance. However, we need a larger and prospective study with a longer follow-up to confirm these preliminary results.

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