WOFAPS 2025 8th World Congress of Pediatric Surgery

Chandramouli Goswami, Anjan Kumar Dhua, Sandeep Agarwala

All India Institute of Medical Sciences, New Delhi

Introduction:
Esophageal strictures in pediatric patients pose significant management challenges, often necessitating complex surgical intervention. Thoracoscopic esophagectomy with esophageal replacement has emerged as a feasible and promising minimally invasive approach. This abstract presents our surgical technique and outcomes in three pediatric cases with severe, refractory esophageal strictures.

Methods:
A retrospective review was conducted of three pediatric patients who underwent thoracoscopic esophagectomy for refractory esophageal strictures. Each procedure involved thoracoscopic dissection and mobilization of the diseased esophagus, followed by esophageal replacement. Emphasis was placed on minimizing surgical trauma and optimizing functional recovery.

Results:
All three children (median age: six years; male:female ratio, 1:2) were successfully treated with thoracoscopic esophagectomy and esophageal replacement. Of these, one patient had a peptic stricture and two had corrosive strictures. Intraoperative blood loss was minimal, and no major intraoperative complications occurred, demonstrating the technical safety of the thoracoscopic approach. Gastric pull-up was used as the conduit in all cases. Postoperative recovery was uneventful, with no significant complications such as anastomotic leaks. All patients tolerated oral feeds well and showed satisfactory weight gain during a median follow-up period of 5.8 months.

Conclusion:
Our experience demonstrates that thoracoscopic esophagectomy with esophageal replacement is a safe and effective minimally invasive option for managing severe esophageal strictures in children. This approach enables precise dissection, reduces operative trauma, and supports favorable postoperative recovery and functional outcomes.