Musculoskeletal deformities after thoracoscopic versus conventional open repair for esophageal atresia.

BACKGROUND: The superiority of thoracoscopic repair (TR) over conventional open repair (COR) for esophageal atresia, especially in terms of long-term outcomes, remains to be investigated. The aim of this study was to compare short- and long-term results between TR and COR group. METHODS: Patients who underwent TR or COR for esophageal atresia without other predispositions to musculoskeletal deformities (2003-2016) and had been followed up for a minimum of 5 years were retrospectively reviewed. Musculoskeletal deformities (e.g., scoliosis, chest wall asymmetry, and rib deformities) were mainly evaluated based on the most recent chest radiographs. RESULTS: Nine and eight patients were included in the TR and COR groups, respectively; the mean follow-up period was 8.7 and 11.5 years, respectively (p = 0.14). These groups had similar epidemiological characteristics and rates of postoperative complications. Musculoskeletal deformities developed significantly less frequently in the TR group versus the COR group (11 % vs. 88 %, p < 0.05; scoliosis: 0 % vs. 38 %, p = 0.08; chest wall asymmetry: 11 % vs. 50 %, p = 0.14; and rib deformities: 11 % vs. 88 %, p < 0.05, respectively). CONCLUSION: TR was associated with a decreased incidence of musculoskeletal deformities and comparable complication rates versus COR for esophageal atresia repair. TR may achieve better long-term outcomes in this setting.

[A case of primary leiomyosarcoma of the small bowel with hepatic portal venous gas].

A 92-year-old woman was admitted with speech disturbance. She had severe anemia (hemoglobin, 6.3g/dl), and abdominal ultrasonography revealed hepatic portal venous gas and an intra-abdominal tumor. Abdominal computed tomography also revealed an irregularly enhanced intra-abdominal tumor, 32x35mm in diameter, which was surgically resected. The tumor was located in the small intestine. Histopathological examination revealed spindle-shaped atypical cells. Immunological evaluation showed the tumor to be SMA (+), c-kit (-), CD34 (-), S100 (-). The Ki-67/MIB1 labeling index was 2.3%. The tumor was diagnosed as leiomyosarcoma of the small bowel. The patient recovered after surgery and was discharged.