{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T23:08:44Z","timestamp":1784243324912,"version":"3.55.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study aimed to evaluate whether preservation of the azygos vein influences postoperative outcomes in infants undergoing repair of esophageal atresia with tracheoesophageal fistula (EA-TEF).<\/jats:p>\n                  <jats:p>A systematic review and meta-analysis were conducted using six major databases, identifying all relevant studies published up to January 2025. Seven studies met the inclusion criteria, including five randomized controlled trials and two retrospective analyses. Outcomes assessed were anastomotic leaks, esophageal strictures, chest infections, and mortality.<\/jats:p>\n                  <jats:p>Across studies, azygos vein preservation was generally associated with fewer postoperative complications compared with ligation. Preservation of the azygos vein appeared to reduce the risk of anastomotic leak, chest infection, and mortality, while also showing a trend toward fewer strictures. However, the strength of evidence was limited by study heterogeneity, small sample sizes, and variation in surgical techniques.<\/jats:p>\n                  <jats:p>This systematic review and meta-analysis suggest that preserving the azygos vein may be beneficial in reducing major postoperative complications. Nevertheless, because most included studies were small and of mixed quality, these findings should be interpreted with caution. Larger, high-quality randomized trials are needed to confirm whether azygos vein preservation directly improves clinical outcomes.<\/jats:p>","DOI":"10.1055\/a-2787-2370","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:05:57Z","timestamp":1768953957000},"page":"270-278","source":"Crossref","is-referenced-by-count":0,"title":["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"],"prefix":"10.1055","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6220-850X","authenticated-orcid":false,"given":"Cecilia G.","family":"Heitsman","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Cleveland Clinic, Cleveland, Ohio, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustafa","family":"Azizo\u011flu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Basaksehir City Hospital, Ba\u015fak\u015fehir, \u0130stanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5666-8830","authenticated-orcid":false,"given":"Marta","family":"Gazzaneo","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of Pavia, Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahsin O.","family":"Kamci","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Bitlis Tatvan State Hospital, Bitlis, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Escolino","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Federico II University Hospital, Naples, Campania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergey","family":"Klyuev","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, AO GK MEDSI, Moscow, Russian Federation"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esra","family":"Karakas","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ministry of Health Elbistan State Hospital, Elbistan, Kahramanmara\u015f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toni","family":"Risteski","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ss Cyril and Methodius University in Skopje, Skopje, North Macedonia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0952","authenticated-orcid":false,"given":"Sonia","family":"P\u00e9rez-Bert\u00f3lez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Hospital Sant Joan de D\u00e9u, Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria F.","family":"Marenco Gutierrez","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Fernando Velez Paz Hospital, Managua, Nicaragua"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Pederiva","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore Fabio","family":"Chiarenza","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, San Bortolo Hospital of Vicenza, Vicenza, Veneto, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annika","family":"Mutanen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, New Children's Hospital, Helsinki, Uusimaa, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Pediatric Surgery, Federico II University, Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"issue":"01","key":"ref1","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s00383-024-05724-x","article-title":"Thoracoscopic primary repair is useful for esophageal atresia with tracheoesophageal fistula in neonates with low body weight","volume":"40","author":"Y Gohda","year":"2024","journal-title":"Pediatr Surg Int"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1089\/lap.2019.0611","article-title":"Clinical analysis of azygos vein preservation under thoracoscope in the operation of type III esophageal atresia","volume":"30","author":"X 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