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. 2022 Mar 10;9(3):387.
doi: 10.3390/children9030387.

Telementoring in Minimally Invasive Esophageal Atresia Repair: Results of a Case-Control Study and Lessons Learned from the TIC-PEA Study (Telemedical Interdisciplinary Care for Patients with Esophageal Atresia)

Tatjana Tamara König  1 , Maria-Christina Stefanescu  1 , Emilio Gianicolo  2   3 , Anne-Sophie Holler  4 , Oliver J Muensterer  4
Affiliations

Telementoring in Minimally Invasive Esophageal Atresia Repair: Results of a Case-Control Study and Lessons Learned from the TIC-PEA Study (Telemedical Interdisciplinary Care for Patients with Esophageal Atresia)

Tatjana Tamara König et al. Children (Basel). .

Abstract

Minimally invasive esophageal atresia (EA) repair is deemed one of the most demanding procedures in pediatric surgery. Open repair is considered the gold standard and learning opportunities for minimally invasive repairs remain scarce. "Telemedical Interdisciplinary Care for Patients with Esophageal Atresia (TIC-PEA)" offers free access to an interdisciplinary network of experts for telemedical consultation (telementoring). The aim of this study was to determine the frequency of minimally invasive surgery (MIS) in TIC-PEA patients compared to the general population. TIC-PEA patients were matched and compared to controls regarding the use of MIS, patient characteristics, and complications. Patients (n = 31) were included at a mean age of 62.8 days (95%-CI: 41.4-84.3, 77% after the primary esophageal repair). The odds-ratio to have MIS was 4.03 (95%-confidence interval: 0.79-20.55) for esophageal anastomosis and 4.60 (95%-confidence interval: 0.87-24.22) for tracheoesophageal fistula-repair in the TIC-PEA group. Telementoring offered the chance to select the ideal candidate for MIS, plan the procedure, and review intraoperative images and videos with the expert. Telementoring as offered is ideal to promote MIS for EA and helps to address the individual learning curve. In order to maximize benefits, patients need to be included prior to the first esophageal procedure.

Keywords: esophageal atresia; minimally invasive surgery; telemedicine; telementoring; thoracoscopy.

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Conflict of interest statement

The authors declare there is no conflict of interest.

Figures

Figure 1
Figure 1
Percentage of minimally invasive vs. open primary anastomosis and tracheoesophageal fistula-repair in the historic control group in patients with esophageal atresia/tracheoesophageal fistula (Gross Type B/C/D, n = 242) of the patient registry (courtesy of the German esophageal atresia patient support group KEKS e.V.). *: minimally invasive surgery.
Figure 2
Figure 2
Forest plot of the odds-ratio (OR) on a logarithmic scale of Telemedical Interdisciplinary Care for Patients with Esophageal Atresia (TIC-PEA) patients with with esophageal atresia/tracheoesophageal fistula (Gross Type B/C/D, n = 24) with minimally invasive anastomosis (a) or trachea-esophageal-fistula (TEF) repair (b) compared to controls (n = 48) adjusted for birth weight.
See this image and copyright information in PMC

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