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Tracheoplasty for Patients with Pulmonary Artery Sling and Tracheal Stenosis: A Meta-Analysis

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Abstract

We performed this meta-analysis to assess the safety and efficacy of tracheoplasty for patients with pulmonary artery sling (PAS) and tracheal stenosis. Published studies that included surgical treatment of PAS and tracheal stenosis with and without tracheoplasty were identified by searching the PubMed, EMBASE, and Cochrane Library databases until May 2020. The outcomes assessed included postoperative ventilation time, early and late mortality, and follow-up respiratory symptoms. The mean difference (MD)/risk ratio (RR) with 95% confidence intervals (CI) was estimated with a random-effects/fixed-effects model. Subgroup analysis was performed stratified by percentage of patients with tracheal rings. A total of eight studies comprising 219 patients with PAS accompanied by tracheal stenosis were included. The pooled estimates of postoperative ventilation time (MD 17.68, 95% CI 6.38 to 28.98, p < 0.01) and early mortality (RR 3.93, 95% CI 1.55 to 9.95, p < 0.01) favored the repair-only group. Late mortality (RR 1.33, 95% CI 0.48 to 3.68, p = 0.58) and respiratory symptoms (RR 1.51, 95% CI 0.50 to 4.57, p = 0.47) at follow-up showed no significant differences between the groups with repair-only and repair with tracheoplasty. The same results were found in subgroup analyses. For the surgical treatment of PAS with tracheal stenosis, repair without tracheoplasty appears to result in shorter postoperative ventilation time and lower early mortality, with no increase in late mortality or respiratory symptoms at follow-up, compared with concomitant tracheoplasty.

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Acknowledgements

None declared.

Funding

This study was funded by the China Post-Doctoral Science Foundation (No. 2019TQ0219) and Post-Doctor Research Project, West China Hospital, Sichuan University (No. 2019HXBH019). The study is registered on PROSPERO (CRD42019139788).

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, People’s Republic of China

    Dongxu Li

  2. Evidence-Based Medicine Research Center, Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, People’s Republic of China

    Xu Zhou

  3. Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, People’s Republic of China

    Mengsi Li

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  1. Dongxu Li
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  2. Xu Zhou
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  3. Mengsi Li
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Correspondence to Dongxu Li.

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Li, D., Zhou, X. & Li, M. Tracheoplasty for Patients with Pulmonary Artery Sling and Tracheal Stenosis: A Meta-Analysis. Pediatr Cardiol 41, 1376–1385 (2020). https://doi.org/10.1007/s00246-020-02386-z

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