Delayed Thoracoscopic Repair Following Abdominal Esophageal Banding in a 539‐g Infant With Triple Atresia: A Case Report
Kaito Hayashi, Chiyoe Shirota, Takahisa Tainaka, Satoshi Makita, Katsuhiro Ogawa, Masamune Okamoto, Akihiro Yasui, Aitaro Takimoto, Shunya Takada, Daiki Kato, Hiroki Ishii, Hajime Asai, Kazuki Ota, Hiroo UchidaABSTRACT
Triple atresia, comprising esophageal atresia, duodenal atresia, and anorectal malformation, has no established management strategy in extremely low‐birth‐weight (ELBW) infants. We report successful staged treatment in a 539‐g infant with severe respiratory failure. Transabdominal esophageal banding and gastrostomy on Day 0 controlled airflow through the tracheoesophageal fistula without thoracic intervention. Duodeno‐duodenostomy and transverse colostomy were performed on Day 18 (680 g), permitting enteral feeding. After growth to 1924 g, thoracoscopic repair of Gross type C esophageal atresia was completed on Day 127. The temporary band was removed without esophageal injury. The patient was discharged on Day 219 at 2793 g with partial oral intake and no anastomotic stricture. This abdominal‐first strategy served as a bridge from cardiorespiratory stabilization and enteral nutrition to delayed thoracoscopic repair while preserving an unoperated thoracic cavity.