The cause of dysphagia in patients with esophageal atresia: a systematic review and meta-analysis
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In brief
In brief
Systematic review and meta-analysis examining the relationship between surgical complications and dysphagia in esophageal atresia patients found no significant association between anastomotic stricture and swallowing difficulties. The authors conclude that dysphagia in EA is multifactorial and recommend comprehensive registry systems to better understand contributing factors beyond surgical outcomes.
Written by the GCMD Library team from the article.
Abstract
Purpose
Dysphagia is the most common symptom in patients with esophageal atresia (EA) of all ages. There is no study addressing the direct relation between dysphagia and surgical results. Therefore, a systematic review was performed to define the relationship between surgical complications and dysphagia in patients with EA.
Methods
The systematic review was drafted under PRISMA guidelines. Systematic literature search was performed for the period 2000 (Jan) to 2019 (Dec)—20 years—in the databases: MEDLINE, EMBASE, and PubMed. Statistical analysis was performed using Comprehensive Meta-Analysis Version 3.0 software.
Results
Among 767 articles, 486 abstracts were screened for the inclusion criteria. The full-texts of 64 articles were assessed for eligibility. The sub-group analysis could be performed in 4 articles for anastomotic strictures. Heterogeneity was calculated by I2 statistic as 18,487 and pooled odds ratio was measured under the fixed effect model (Q = 3.68; P = 0.298, I2 = 18,487). There was no significant relationship with an odds ratio of 1.37 between anastomotic stricture (AS) and dysphagia (95% CI 0.631–2.973, p = 0.426). There was no publication bias for the data (Begg’s test, p = 0.496; Egger’s tests, p = 0.335).
Conclusion
This meta-analysis did not reveal a significant relationship between AS and dysphagia in children with EA. Since many other factors contribute to dysphagia, comprehensive variable information such as detailed standardized registry systems for rare diseases for pooling analysis is needed regarding other potential factors including surgical complications.