Gender and birth weight as risk factors for anastomotic stricture after esophageal atresia repair: a systematic review a
- PDF / 904,053 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 107 Downloads / 183 Views
RESEARCH ARTICLE
Open Access
Gender and birth weight as risk factors for anastomotic stricture after esophageal atresia repair: a systematic review and meta-analysis Anahid Teimourian1, Felipe Donoso2,3, Pernilla Stenström1,4, Helena Arnadottir1,4, Einar Arnbjörnsson1,4, Helene Lilja2,3 and Martin Salö1,4*
Abstract Background: Anastomotic stricture (AS) is the most frequently occurring complication that occurs after esophageal atresia (EA) repair. Nevertheless, the pathogenesis remains primarily unknown and there is inadequate knowledge regarding the risk factors for AS. Therefore, a systematic review of the literature and a meta-analysis was performed to investigate whether gender and birth weight were risk factors for the development of AS following EA repair. Methods: The main outcome measure was the occurrence of AS. Forest plots with odds ratios (OR) and 95% confidence intervals (CI) were generated for the outcomes. Quality assessment was performed using the Newcastle–Ottawa scale. Results: Six studies with a total of 495 patients were included; 59% males, and 37 and 63% of the patients weighed < 2500 g and ≥ 2500 g, respectively. Male gender (OR, 0.96; 95% CI, 0.66–1.40; p = 0.82) and birth weight < 2500 g (OR, 0.74; 95% CI, 0.47–1.15; p = 0.18) did not increase the risk of AS. The majority of the included studies were retrospective cohort studies and the overall risk of bias was considered to be low to moderate. Conclusion: Neither gender nor birth weight appear to have an impact on the risk of AS development following EA repair. Keywords: Anastomotic stricture, Birth weight, Esophageal atresia repair, Gender, Meta-analysis, Risk factors
Background Esophageal atresia (EA) is a rare congenital anomaly that occurs in 1:2500 to 1:4000 live-born children [1]. The survival rate has increased to up to 91–99% in the past decade [2–5]. Excluding the immediate postoperative complications, the most frequently occurring complication affecting postoperative morbidity is the development * Correspondence: [email protected] 1 Department of Clinical Sciences, Pediatrics, Lund University, Lund, Sweden 4 Department of Pediatric Surgery, Skåne University Hospital, Lasarettsgatan 48, 221 85 Lund, Sweden Full list of author information is available at the end of the article
of anastomotic strictures (AS) [6]. The rate of AS after EA repair varies with different studies, and a universal definition is lacking; however, approximately 32–59% of children are expected to require at least one dilatation during their lifetime [6]. Only a few risk factors for developing AS are known thus far, and their incidence may be affected by the type of EA. Long-gap EA, which is exposed to increased tension in the anastomosis, is considered to be more likely to form AS; in addition, recent studies confirm that anastomotic tension is an independent risk factor of AS development [7, 8]. Earlier research also suggested that
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International Licen
Data Loading...
