The beneficial effects of the transanastomotic feeding tube in the management of congenital duodenal obstruction: a meta-analysis.

Objective: We aimed to assess the evidence on the efficacy and safety of transanastomotic feeding tubes (TAFTs) in neonates with congenital duodenal obstruction (CDO), we conducted a systematic review.

Material and methods: Using the databases EMBASE, PubMed, and Cochrane, we carried out a thorough literature search up to 2022. Studies comparing TAFT + and TAFT - for CDO were included. We applied a random effect model.

Results: 505 CDO patients who met the inclusion criteria were selected. The TAFT + group had a shorter time to reach full feeds (weighted mean difference [WMD]: -6.63, 95% confidence interval [CI]: -8.83 - -4.43; p < 0.001) and had significantly less central venous catheter (CVC) insertion (I² = 85%) (RR: 0.43, 95% CI: 0.19-1.00; p < 0.05). Fewer patients in the TAFT + group received parenteral nutrition (PN) (I² = 78%) (RR: 0.43, 95% CI: 0.20-0.95; p < 0.05). There was no statistically significant difference in terms of the development of sepsis (I² = 37%) (risk ratio [RR]: 1.35, 95% CI: 0.52-3.46; p > 0.05). No statistically significant difference was observed in terms of length of stay (I² = 82%) (WMD: 2.22, 95% CI: -7.59-12.03; p > 0.05) and mortality (I² = 0%) (RR: 0.55, 95% CI: 0.07-4.34; p > 0.05).

Conclusions: The use of the transanastomotic tube resulted in early initiation of full feeding, less CVC insertion, and less need for PN.