EN
TÜRKÇE
Poster - 21
Nerve injury and vocal cord paralysis after esophageal atresia and tracheoesophageal fistula: Systematic review and meta-analysis
T Soyer*, SM Akıncı**, B Pişiren**, UE Arslan***, Ö Boybeyi**
*Department of Pediatric Surgery, Hacettepe University, Faculty of Medicine, Ankara, Türkiye
**Department of Pediatric Surgery, Faculty of Medicine, Hacettepe University, Ankara, Turkiye
***Department of Health Research, Hacettepe University, Institute of Public Health, Ankara, Türkiye
Aim: Vocal cord paralysis (VCP) and recurrent laryngeal nerve injury may be either congenital or acquired due to surgical trauma in patients with esophageal atresia and tracheoesophageal fistula (EA-TEF). A systematic review and meta-analysis were performed to define the risk factors for developing VCP and other nerve injuries.
Methods: Systematic literature search was conducted for the period 2000 (Jan) to 2024 (Jan) under the PRISMA guidelines. The study protocol was registered on PROSPERO (CRD42024532277). EMBASE, MEDLINE and Pubmed databases were searched and qualitative and quantitative data were extracted relating to VCP, recurrent laryngeal and phrenic nerve injury in patients with EA-TEF. Statistical analysis was performed with CMA-V4 software.
Results: Among 1421 articles, 851 abstracts were screened for inclusion criteria. Full texts of 125 articles were assessed for eligibility. The subgroup analysis was performed in 8 articles for type of EA-TEF and 4 articles for type of surgery. The risk of VCP occurrence was increased 1.58 times in Type-A, 2,38 times in Type-B and 6,96 times in Type -E when compared to Type-C EA [95%CI: (0,95-2,63, p=0.08), (08-5,26, p=0.032), (3,57-13,57, p<0,05), respectively]. There was no significant correlation between thoracotomy and thoracoscopy to risk of VCP occurrence [OR:1.74, (95% CI 0,69-4,37), p=0.24]. Kendal’s Tau test and Egger’s tests were performed revealing that there was no publication bias for all data.
Conclusions: This systematic review reveals that the occurrence of VCP significantly increases in rare types (A, B and E) of EA-TEF compared to Type-C. Whereas, the type of the surgery seems to be non-correlated with the VCP occurrence risk.