Objective To determine the impact of transanastomotic tube (TAT) feeding in congenital duodenal obstruction (CDO). Design Systematic review with meta-analysis. Patients Infants with CDO requiring surgical repair. Interventions TAT feeding following CDO repair versus no TAT feeding. Main outcome measures The main outcome was time to full enteral feeds. Additional outcomes included use of parenteral nutrition (PN), cost and complications from either TAT or central venous catheter. Meta-analyses were undertaken using random-effects models (mean difference (MD) and risk difference (RD)), and risk of bias was assessed using the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool. Results Twelve out of 373 articles screened met the inclusion criteria. All studies were observational and two were prospective. Nine studies, containing 469 infants, were available for meta-analysis; however, four were excluded due to serious or critical risk of bias. TAT feeding was associated with reduced time to full enteral feeds (−3.34; 95% CI −4.48 to −2.20 days), reduced duration of PN (−6.32; 95% CI −7.93 to −4.71 days) and reduction in nutrition cost of £867.36 (95% CI £304.72 to £1430.00). Other outcomes were similar between those with and without a TAT including inpatient length of stay (MD −0.97 (−5.03 to 3.09) days), mortality (RD −0.01 (−0.04 to 0.01)) and requirement for repeat surgery (RD 0.01 (−0.03 to 0.05)). Conclusion TAT feeding following CDO repair appears beneficial, without increased risk of adverse events; however, certainty of available evidence is low. Earlier enteral feeding and reduced PN use are known to decrease central venous catheter-associated risks while significantly reducing cost of care. PROSPERO registration number CRD42022328381. Data are available upon reasonable request. Database extracted from published articles available by request.

中文翻译：

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有或没有经吻合管喂养的先天性十二指肠梗阻修复术：系统评价和荟萃分析

目的 确定经吻合管（TAT）喂养对先天性十二指肠梗阻（CDO）的影响。设计系统审查与荟萃分析。患有 CDO 的婴儿需要手术修复。CDO 修复后 TAT 喂养与无 TAT 喂养的干预措施。主要结果指标 主要结果是完全肠内喂养的时间。其他结果包括肠外营养 (PN) 的使用、TAT 或中心静脉导管的费用和并发症。使用随机效应模型（平均差（MD）和风险差（RD））进行荟萃分析，并使用干预措施的非随机研究中的偏倚风险（ROBINS-I）工具评估偏倚风险。结果 筛选的 373 篇文章中有 12 篇符合纳入标准。所有研究都是观察性的，其中两项是前瞻性的。包含 469 名婴儿的 9 项研究可用于荟萃分析；然而，由于严重或严重的偏倚风险，四人被排除在外。TAT 喂养与完全肠内喂养时间缩短（−3.34；95% CI -4.48 至 -2.20 天）、PN 持续时间缩短（−6.32；95% CI -7.93 至 -4.71 天）以及营养成本降低相关。 867.36 英镑（95% CI 304.72 英镑至 1430.00 英镑）。接受和不接受 TAT 的其他结果相似，包括住院时间（MD -0.97（-5.03 至 3.09）天）、死亡率（RD -0.01（-0.04 至 0.01））和重复手术的要求（RD 0.01（ −0.03 至 0.05))。结论 CDO 修复后 TAT 喂养似乎有益，且不会增加不良事件的风险；然而，现有证据的质量很低。众所周知，早期肠内喂养和减少 PN 使用可以降低中心静脉导管相关风险，同时显着降低护理成本。PROSPERO 注册号 CRD42022328381。数据可根据合理要求提供。从已发表的文章中提取的数据库可根据要求提供。