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. 2022 Jul 28:10:965275.
doi: 10.3389/fped.2022.965275. eCollection 2022.

Azygos vein preservation is feasible and beneficial in esophageal atresia with tracheoesophageal fistula: A meta-analysis of randomized controlled trials

Chuan Wang  1 , Junkai Zheng  1 , Xue Ma  1
Affiliations

Azygos vein preservation is feasible and beneficial in esophageal atresia with tracheoesophageal fistula: A meta-analysis of randomized controlled trials

Chuan Wang et al. Front Pediatr. .

Abstract

Background: Esophageal atresia (EA) with tracheoesophageal fistula (TEF) is a common congenital anomaly. It is still unknown whether azygos vein preservation will increase the difficulty or time of operation and reduce the quality of anastomosis. Thus, we conducted this meta-analysis to explore the puzzle.

Methods: Two researchers independently searched the databases. Randomized controlled trials were included if these studies applied thoracotomy to perform operations and compared the outcomes in patients with EA/TEF between azygos vein preservation groups and azygos vein ligation groups. The Jadad score was used to assess the quality of the included studies. Statistical heterogeneity was evaluated using the I 2 value. A fixed or random-effect model was applied regarding the I 2 value.

Results: Four studies involving 286 patients were included. The pooled estimates indicated that preservation of the azygos vein decreased the incidence of anatomic leakage with a pooled risk ratio (RR) of 0.54 (95% CI 0.29-0.99, P = 0.05) and mortality with an RR of 0.51 (95% CI 0.29-0.90; P = 0.02). Preservation of the azygos vein might not require a longer operative time than ligation of the azygos vein.

Conclusions: This research certifies that preservation of the azygos vein is able to reduce the prevalence of anastomotic leakage and mortality.

Keywords: anatomic leak; azygos vein; complication; esophageal atresia; mortality.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of study selection.
Figure 2
Figure 2
Forest plot showing the risk ratio for the occurrence of anastomotic leakage in the two groups.
Figure 3
Figure 3
Forest plot showing the risk ratio for the occurrence of mortality in two groups.
See this image and copyright information in PMC

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