Proton pump inhibitors in esophageal atresia: A systematic review and meta-analysis.
J Pediatr Gastroenterol Nutr
; 78(3): 457-470, 2024 Mar.
Article
en En
| MEDLINE
| ID: mdl-38262739
ABSTRACT
Gastroesophageal reflux disease (GERD) is frequent and prolonged in esophageal atresia (EA) pediatric patients requiring routine use of proton pump inhibitors (PPIs). However, there are still controversies on the prophylactic use of PPIs and the efficacy of PPIs on GERD and EA complications in this special condition. The aim of the study is to assess the prophylactic use of PPIs in pediatric patients with EA and its complications. We, therefore, performed a systematic review including all reports on the subject from 1980 to 2022. We conducted meta-analysis of the pooled proportion of PPI-and no PPI groups using random effect model, meta-regression, and estimate heterogeneity by heterogeneity index I2 . Thirty-eight reports on the topic met the criteria selection, representing a cumulative 6044 patients with EA. Prophylactic PPI prescription during the first year of life does not appear to prevent GERD persistence at follow-up and is not associated with a significantly reduced rate of antireflux surgical procedures (ARP). PPIs improve peptic esophagitis and induce remission of eosinophilic esophagitis at a rate of 50%. Their effect on other GERD outcomes is uncertain. Evidence suggests that PPIs do not prevent anastomotic stricture, Barrett's esophagus, or respiratory complications. PPI use in EA can improve peptic and eosinophilic esophagitis but is ineffective on the other EA complications. Side effects of PPIs in EA are almost unknown.
Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Reflujo Gastroesofágico
/
Atresia Esofágica
/
Inhibidores de la Bomba de Protones
Tipo de estudio:
Prognostic_studies
/
Systematic_reviews
Límite:
Child
/
Humans
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Año:
2024
Tipo del documento:
Article
País de afiliación:
Francia