Affected by atresia of the esophagus and esophagus-tracheal fistula
It was carried out in Siena, al polyclinic of Santa Maria alle Scotte, an intervention by pediatric surgery unique in Tuscany and among the few in Italy, in thoracoscopy, on a child born with a severe malformation of the digestive tract, called atresia of the esophagus, in which the esophagus does not connect with the stomach but communicates with the trachea. The child, born at the Arezzo hospital, presented at birth a pluri-malformative picture, which included other malformations, and was promptly stabilized and made safe by the neonatologists of the Neonatology Department of the San Donato hospital in Arezzo, directed by Dr. Letizia Magi. The newborn was therefore transported to Siena with the ambulance dedicated to the neonatal transport of the Sienese university hospital, where she was taken over by the neonatologists and the nurses of the Neonatal Intensive Care, directed by Dr. Barbara Tomasini. “The newborn was born with various malformations and we immediately intervened on what was incompatible with life, that is the atresia of the esophagus – explains professor Mario Messina, director of the Department of Women and Children and of the UOC Pediatric Surgery of the Aou Senese -. He will subsequently undergo two other interventions, always carried out by our Pediatric Surgery, to solve other care needs. As soon as she arrived in Siena – Messina continues -, she was immediately subjected to all the preoperative examinations with the collaboration of the Diagnostic Imaging Department, directed by Professor Luca Volterrani and with the colleagues of Clinical-Surgical Cardiology, directed by Doctor Serafina Valente. The esophagus appeared, in the upper part, closed on a blind bottom and, in the lower part, connected to the trachea with a fistula. On the third day of life, the little patient, who weighed 2.4 kg, underwent a delicate reconstruction of the esophagus and trachea conducted with the thoracoscopic technique, through 4 small holes of 5 and 3 millimeters on the chest, instead of with the traditional surgical intervention “.
The operation was carried out by the professor Francesco Molinaro and the doctor Marina Sica of the Pediatric Surgery team, directed by Professor Mario Messina. “The operation lasted about 4 hours – explains Professor Molinaro -, with great dedication by the operating room nurses and all the operating room staff, assisted by the pediatric anesthetists of the Anesthesia and Perioperative Resuscitation, directed by Dr. Pasquale d ‘ Onofrio. The little patient started eating 10 days after the operation and did not present any postoperative complications. She is currently hospitalized in the sub-intensive area, cared for by medical and nursing staff, assisted by pediatric physiotherapists. Interventions of this type are also possible thanks to the work of pediatric esthetists who can operate on the surgeon to be able to operate with low weight in conditions of absolute stability and safety. The surgery of the neonatal esophagus in thoracoscopy is performed regularly in Siena and testimonies, not only the high level of specialization in minimally invasive neonatal surgery, but also the validity of the pediatric and neonatal network of the vast south-east Tuscany area ” .