Prophylactic intraoperative chest drain insertion in esophag
There is no additional benefit of chest drain insertion during surgical repair of Esophageal atresia-tracheoesophageal fistula (EA-TEF) in terms of the requirement of a chest drain in the postoperative period, the incidence of postoperative complications, revisits to the operating room, and mortality.

Routine intraoperative chest drain (IOCD) insertion is often debated and lacks any concrete evidence. This meta-analysis aims to compare the postoperative outcomes among newborns with and without IOCD insertion.

The authors searched EMBASE, PubMed, Scopus, and Web of Science. The requirement for chest drain in the postoperative period (POCD), anastomotic leak (and/or pneumothorax), mortality rate, and revisit(s) to the operation room (RVOR) were compared among two groups of newborns, i.e. groups A and B with and without IOCD insertion respectively. A total of 498 newborns were included in the present analysis.

- As compared to group B, newborns within group A showed no significant difference in the requirement for POCD, the occurrence of anastomotic leak and/or pneumothorax, and mortality rate.

- However, RVOR was significantly higher in group A.

The present meta-analysis revealed no additional benefit of prophylactic IOCD insertion.

Journal of Pediatric Surgery