Pediatric quality of life post esophageal atresia repair: A systematic review and meta-analysis.

PURPOSE: Provide a quantitative overview on pediatric quality of life (QoL) and its dimensions after esophageal atresia (EA) and/or tracheoesophageal fistula (TEF) repair.

METHODS

A systematic search of MEDLINE, PsycInfo, EBM Reviews, and Embase was conducted through December 07, 2023. Studies assessing QoL in pediatric patients after EA/TEF repair were included. The primary outcome was overall QoL; secondary outcomes included physical, emotional, social, and school functioning. A common and random effects meta-analysis was conducted, with subgroup analyses based on age and respondent type. Risk of bias was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

RESULTS

Of 321 articles screened, 9 were eligible for meta-analysis. Overall, the QoL mean was 78.83 (95 % CI [76.86; 80.80], I2=0 %, p = 0.71). Parent- or child-reported overall means were 82.66 (95 % CI [76.00; 89.32], I2=0 %, p = 0.71) and 85.74 (95 % CI [80.79; 90.68], I2=0 %, p = 0.71), respectively. Physical and social functioning consistently scored higher than other QoL dimensions, regardless of respondent type or age groups. For example, Parent-reported physical functioning in children 8-17 years showed a pooled mean score of 87.13 (95 % CI [80.08, 94.19], I2=88 %, p < 0.01), while psychosocial functioning had a lower mean score of 76.38 (95 % CI [65.03, 79.11], I2=92 %, p<0.01).

CONCLUSION

Children post-EA/TEF repair have overall high QoL scores comparable to those reported in other surgically treated neonatal conditions. Within the QoL domains, physical and social functioning scores are higher, while emotional, school, and psychosocial domain scores are lower, highlighting areas for potential multidisciplinary follow up.

LEVEL OF EVIDENCE: V.

TYPE OF STUDY: Reviews, Systematic Reviews, Meta-Analysis.