INoEA 2025 7th International Conference on Esophageal Atresia & 11th International PAAFIS Symposium & Aerodigestive Society Meeting

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Oral Presentation - 36

Pulmonary function in childhood after thoracoscopic esophageal atresia repair

T Teunissen, L Magni, D Focke, J Verweij, E Reuling, j Bittermann, M Lindeboom, B Arets, S Tytgat
Department of Pediatric Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht

Purpose

Respiratory morbidity and pulmonary function impairment (PFI) are common after esophageal atresia (EA) repair. Pulmonary function has not been extensively evaluated in large cohorts following thoracoscopic EA repair. This study aims to assess pulmonary function during childhood in patients who underwent thoracoscopic EA repair.

Methods

A retrospective observational study was conducted at our center, including patients who underwent thoracoscopic EA repair between 2006 and 2018 and were able to perform pulmonary function testing. Assessments were conducted at ages 5 years, 8 years, 11 years, and 14 years. Results were compared to the 2021 and 2022 Global Lung Function Initiative reference equations.

Results

A total of 82 patients were included. The median Z-scores for FEV1/FVC (forced expiratory volume in the first second of expiration/forced vital capacity) were 0.05, 0.83, -0.21, and -1.27 at ages 5, 8, 11, and 14 years. For TLC (total lung capacity), the median Z-scores were 0.34, -0.59, and -0.66 at ages 8, 11, and 14 years. PFI was classified as obstructive or restrictive. Obstructive PFI was observed in 8.2%, 10.0%, 10.8%, and 15.0% at ages 5, 8, 11, and 14 years. Restrictive PFI was observed in 0.0%, 13.8%, and 5.9% at ages 8, 11, and 14 years.

Conclusion

After thoracoscopic EA repair, obstructive PFI is more common than restrictive PFI. FEV1/FVC, indicative of obstructive PFI, was not significantly lower than in the reference population. TLC, indicative of restrictive PFI, declined with age and was significantly lower than in the reference population. Compared to open EA repair, thoracoscopic EA repair appears to result in fewer PFIs, though this is not based on meta-analysis. PFI following EA repair remains common, underscoring the need for multidisciplinary follow-up to optimize outcomes.

Keywords: Pulmonary function, Esophageal atresia, thoracoscopy, minimally invasive surgery

T Teunissen, L Magni, D Focke, J Verweij, E Reuling, j Bittermann, M Lindeboom, B Arets, S Tytgat
Department of Pediatric Surgery, Wilhelmina Children’s Hospital, University Medical Center Utrecht

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