Thoracoscopic esophageal atresia (EA) repair affords many benefits to the patient; however, intracorporeal suturing of the anastomosis is technically challenging. Esophageal magnetic compression anastomosis (EMCA) is a compelling option for endoluminal EA repair, but available EMCA devices have prohibitive rates of recalcitrant stricture. Connect-EA is a new endoluminal EMCA device system that employs 2 magnetic anchors with a unique mating geometry designed to reliably create a robust anastomosis and decrease rates of leak and stricture. We describe our first-in-human experience with this novel endoluminal device for staged EA repair in 3 patients (Gross type A, B, and C) at high risk for conventional surgical repair. First, the esophageal pouches were approximated thoracoscopically. After acute tension subsided, the device anchors were endoscopically placed in the esophageal pouches and mated. Anchors were spontaneously excreted in 2 cases. Endoscopic repositioning and retrieval of the anchors were required in 1 patient because of narrowed esophageal anatomy. There were no perioperative complications. Patients were managed for 14 to 18 months. The strictures that developed in the patients were membranous and responded well to dilation alone, resolving after 4 to 5 outpatient dilations. Gastrostomies were closed between 6 and 11 months and all patients are tolerating full oral nutrition. Early experience with this new endoluminal EMCA device system is highly favorable. The device offers considerable benefit over conventional handsewn esophageal anastomosis and anastomotic outcomes are superior to available EMCA devices.

胸腔镜食管闭锁 (EA) 修复术给患者带来了许多好处；然而，吻合口的体内缝合在技术上具有挑战性。食管磁力压缩吻合术 (EMCA) 是腔内 EA 修复的一种引人注目的选择，但可用的 EMCA 设备具有令人望而却步的顽固性狭窄率。Connect-EA 是一种新的腔内 EMCA 设备系统，它采用 2 个磁锚和独特的配合几何形状，旨在可靠地创建强大的吻合并降低泄漏和狭窄的速度。我们描述了我们使用这种新型腔内装置对 3 名常规手术修复风险高的患者（大体 A、B 和 C 型）进行分期 EA 修复的首次人类体验。首先，在胸腔镜下接近食管袋。急性紧张感平息后，装置锚在内窥镜下放置在食道袋中并配对。锚钉自发排出2例。由于食管解剖结构狭窄，1 名患者需要内窥镜重新定位和取出锚固件。无围手术期并发症。患者接受了 14 至 18 个月的管理。患者出现的狭窄是膜性狭窄，对单独扩张反应良好，在门诊扩张 4 至 5 次后缓解。胃造口术在 6 到 11 个月之间关闭，所有患者都可以耐受全口营养。这种新型腔内 EMCA 设备系统的早期经验非常有利。与传统手缝食管吻合术相比，该设备具有相当大的优势，并且吻合结果优于现有的 EMCA 设备。