{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T14:54:11Z","timestamp":1775055251951,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Esophageal atresia (EA) with tracheoesophageal fistula (TEF) is a common congenital anomaly. It is still unknown whether azygos vein preservation will increase the difficulty or time of operation and reduce the quality of anastomosis. Thus, we conducted this meta-analysis to explore the puzzle.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two researchers independently searched the databases. Randomized controlled trials were included if these studies applied thoracotomy to perform operations and compared the outcomes in patients with EA\/TEF between azygos vein preservation groups and azygos vein ligation groups. The Jadad score was used to assess the quality of the included studies. Statistical heterogeneity was evaluated using the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> value. A fixed or random-effect model was applied regarding the <jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup> value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Four studies involving 286 patients were included. The pooled estimates indicated that preservation of the azygos vein decreased the incidence of anatomic leakage with a pooled risk ratio (RR) of 0.54 (95% CI 0.29\u20130.99, <jats:italic>P<\/jats:italic> = 0.05) and mortality with an RR of 0.51 (95% CI 0.29\u20130.90; <jats:italic>P<\/jats:italic> = 0.02). Preservation of the azygos vein might not require a longer operative time than ligation of the azygos vein.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This research certifies that preservation of the azygos vein is able to reduce the prevalence of anastomotic leakage and mortality.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2022.965275","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T08:57:06Z","timestamp":1658998626000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":8,"title":["Azygos vein preservation is feasible and beneficial in esophageal atresia with tracheoesophageal fistula: A meta-analysis of randomized controlled trials"],"prefix":"10.3389","volume":"10","author":[{"given":"Chuan","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junkai","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xue","family":"Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1136\/jmg.2005.038158","article-title":"Oesophageal atresia, tracheo-oesophageal fistula, and the VACTERL association: review of genetics and epidemiology","volume":"43","author":"Shaw-Smith","year":"2006","journal-title":"J Med Genet."},{"key":"B2","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1055\/s-0036-1597946","article-title":"Esophageal Atresia with or without Tracheoesophageal Fistula (EA\/TEF): association of different EA\/TEF subtypes with specific co-occurring congenital anomalies and implications for diagnostic workup","volume":"28","author":"Bogs","year":"2018","journal-title":"Eur J Pediatr Surg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1136\/archdischild-2011-300597","article-title":"Oesophageal atresia: prevalence, prenatal diagnosis and associated anomalies in 23 European regions","volume":"97","author":"Pedersen","year":"2012","journal-title":"Arch Dis Child."},{"key":"B4","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1007\/s00383-014-3586-7","article-title":"Thoracoscopic repair of esophageal atresia and tracheo-esophageal fistula in neonates: the current state of the art","volume":"30","author":"Rothenberg","year":"2014","journal-title":"Pediatr Surg Int."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1215","DOI":"10.1007\/s00383-007-2008-5","article-title":"Azygos vein preservation in primary repair of esophageal atresia with tracheoesophageal fistula","volume":"23","author":"Sharma","year":"2007","journal-title":"Pediatr Surg Int."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1635","DOI":"10.1016\/j.jpedsurg.2006.07.004","article-title":"Esophageal atresia. 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