Evidence map›Paper›PMID 40924205›Full record

SynthesisPediatric surgery international2025

Thoracoscopic versus conventional thoracotomy for esophageal atresia/tracheoesophageal fistula repair: a comprehensive meta-analysis of 25 comparative studies.

Amani N Alansari, Marwa Messaoud, Salma Mani, Mohamed Sayed Zaazouee, Hanan Youssif, Amine Ksia

Abstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Amani N AlansariDepartment of Pediatric Surgery, Hamad Medical Corporation, P.O Box: 3050, Doha, Qatar. aalansari9@hamad.qa.ORCID http://orcid.org/0000-0002-9369-1933
Marwa MessaoudPediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.ORCID http://orcid.org/0009-0006-1314-6713
Salma ManiPediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.ORCID http://orcid.org/0000-0002-3258-6873
Mohamed Sayed ZaazoueeFaculty of Medicine, Al-Azhar University, Assiut, Egypt.ORCID http://orcid.org/0000-0003-0904-9153
Hanan YoussifPediatric surgery department, Benghazi medical center, Benghazi district, Benghazi, Libya.ORCID http://orcid.org/0009-0005-6541-6298
Amine KsiaPediatric Surgery Department, Fattouma Bourguiba University Hospital, Monastir, Tunisia.ORCID http://orcid.org/0000-0003-4847-7257

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis meta-analysis compares thoracoscopic versus open thoracotomy repair of esophageal atresia with tracheoesophageal fistula (EA/TEF).

methodsWe systematically searched PubMed, Web of Science, Cochrane Library, and Scopus from inception to April 2025 for studies comparing thoracoscopic versus conventional thoracotomy approaches. Two independent reviewers screened studies, extracted data, and assessed risk of bias using appropriate tools. Meta-analyses were conducted using RevMan 5.4 software.

resultsA total of 25 studies (24 observational and one randomized controlled trial, including 3087 patients) were included. Thoracoscopic repair was associated with longer operative time (mean difference [MD] = 20.94 min; p = 0.005) but showed significant advantages in reducing mortality (risk ratio [RR] = 0.52; p = 0.01), musculoskeletal complications (RR = 0.08; p < 0.0001), and wound infections (RR = 0.21; p = 0.02). It also led to shorter ICU stays (MD = -1.09 days; p = 0.005) and earlier initiation of oral feeding (MD = -1.12 days; p = 0.02). However, the risk of anastomotic stricture requiring dilation was higher (RR = 1.54; p < 0.00001). No significant differences were found in anastomotic leak rates, recurrent fistula, respiratory complications, or need for fundoplication.

conclusionsThoracoscopic repair of EA/TEF is associated with perioperative benefits over conventional thoracotomy, including significantly lower mortality and a markedly reduced incidence of musculoskeletal complications. However, this approach is associated with a higher risk of anastomotic stricture requiring dilation, and these differences may partly reflect patient selection factors.

Indexed as

Esophageal AtresiaThoracoscopyThoracotomyTracheoesophageal FistulaHumansObservational Studies as TopicPostoperative ComplicationsRandomized Controlled Trials as TopicEsophageal atresiaMeta-analysisMinimally invasive surgeryThoracoscopic repairThoracotomyTracheoesophageal fistula

Identifiers

PMID40924205
PMCPMC12420690

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.