This meta-analysis was designed to determine the effect of an intracardiac lateral tunnel (ILT) versus an extracardiac conduit (ECC) on patients undergoing a Fontan procedure. A search of the literature in PubMed, Embase, China Academic Literature, and Wanfang databases yielded 23 studies comprising approximately 1000 patients for analysis. There were statistically significant differences between ILT and ECC in the frequency of early sinus node dysfunction, early total arrhythmias, late supraventricular tachycardia, late sinus node dysfunction, late total arrhythmias, and need for pacemaker. By contrast, no statistically significant differences between the two methods were found in takedown, protein-losing enteropathy, thromboembolic events, early supraventricular tachycardia, early mortality, and total mortality. We conclude that an ECC confers some advantages over an ILT, although the underlying mechanism remains unclear.

OBJECTIVE: The quality of paediatric clinical practice guidelines (CPGs) for the management of Mycobacterium tuberculosis infection is unclear. We aimed to comprehensively assess the quality of these CPGs and identify areas requiring improvement.DESIGN: CPGs were systematically searched and identified before being appraised by independent reviewers using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and Reporting Items for Practice Guidelines in HealThcare (RIGHT) tools. Inter-rater reliability was assessed using intra-class correlation coefficient (ICC).RESULTS: Twenty-five CPGs were evaluated. All CPG agreements among four reviewers were good (ICC 0.753–0.939). The mean CPG score was 50.5% (23.5–78.4%), and seven CPGs were recommended for use. The mean scores of three domains were low: 38% for stakeholder involvement (5.6–93.1%), 38.4% for rigour of development (1–97.4%) and 36.3% for applicability (12.5–64.6%). The mean reporting rate of Reporting Items for Practice Guidelines in HealThcare fields was 41.8%, and the evidence field had the highest reporting rate (63.1%), while the review and quality assurance field had the lowest rate (15.4%) for CPGs that include methods.CONCLUSION: The methodological and reporting quality of the CPGs was variable and poor, respectively. More effort is needed in stakeholder involvement, rigour of development, applicability domains and reporting to produce higher-quality CPGs.