AUTHOR=Wang Chuan , Zheng Junkai , Ma Xue 

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

JOURNAL=Frontiers in Pediatrics

VOLUME=10

YEAR=2022

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.965275

DOI=10.3389/fped.2022.965275

ISSN=2296-2360

ABSTRACT=<sec><title>Background</title><p>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.</p></sec><sec><title>Methods</title><p>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 <italic>I</italic><sup>2</sup> value. A fixed or random-effect model was applied regarding the <italic>I</italic><sup>2</sup> value.</p></sec><sec><title>Results</title><p>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, <italic>P</italic> = 0.05) and mortality with an RR of 0.51 (95% CI 0.29–0.90; <italic>P</italic> = 0.02). Preservation of the azygos vein might not require a longer operative time than ligation of the azygos vein.</p></sec><sec><title>Conclusions</title><p>This research certifies that preservation of the azygos vein is able to reduce the prevalence of anastomotic leakage and mortality.</p></sec>