Impact of Azygos Vein Preservation on Postoperative Outcomes in Esophageal Atresia: A Systematic Review and Meta-Analysis from the Pediatric Surgery Meta-Analysis (PESMA) Study Group

Topic overview

Key takeaways

• Azygos vein preservation during EA-TEF repair may reduce anastomotic leaks, chest infections, and mortality compared to ligation.
• Meta-analysis of 7 studies shows trend toward fewer strictures with azygos preservation, though evidence quality is limited.
• Current evidence is constrained by small sample sizes and heterogeneous surgical techniques across studies.
• Larger randomized controlled trials are needed to definitively establish clinical benefit of azygos vein preservation.
• Consider preserving azygos vein when technically feasible during esophageal atresia repair based on available evidence.

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