Letter to the Editor Comment on : Preservation of the azygos vein versus ligation of the azygos vein during surgical repair of esophageal atresia-tracheoesophageal fistula-a systematic review and meta-analysis

jpedsurg.org

We read with interest the systematic review and meta-analysis by Shahid et al [1]. comparing preservation versus ligation of the azygos vein during primary repair of esophageal atresia with tracheoesophageal fistula. The authors synthesized an important body of literature addressing a long-standing technical debate in pediatric surgery, and their effort to pool randomized and non-randomized evidence is commendable.

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Article · Feb 2026 · 1 min read

In brief

This letter responds to a systematic review comparing azygos vein preservation versus ligation during surgical repair of esophageal atresia with tracheoesophageal fistula. The commentary addresses a technical debate in pediatric surgery regarding optimal surgical approach for this congenital anomaly.

Azygos vein management during EA-TEF repair remains a debated technical decision in pediatric surgery.
Systematic review compared preservation vs ligation approaches using pooled randomized and observational data.
Evidence synthesis addresses long-standing surgical technique controversy with clinical implications for outcomes.

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