Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach
| Autor: | Marc G. Schlatter, Neal D. Uitvlugt, Kristen Norris, James M. DeCou, Robert H. Connors |
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| Rok vydání: | 2003 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Birth weight Gestational Age Fasciotomy Abdominal wall Postoperative Complications Enterocolitis Necrotizing Pregnancy medicine Humans Retrospective Studies Gastroschisis business.industry Infant Newborn Gestational age Retrospective cohort study Prostheses and Implants General Medicine Length of Stay Delivery Obstetric medicine.disease Respiration Artificial Surgery Treatment Outcome medicine.anatomical_structure Parenteral nutrition Anesthesia Pediatrics Perinatology and Child Health Female Parenteral Nutrition Total business Maternal Age |
| Zdroj: | Journal of Pediatric Surgery. 38:459-464 |
| ISSN: | 0022-3468 |
| Popis: | The aim of this study was to critically evaluate the clinical outcomes of two different surgical treatment approaches for infants born with gastroschisis.The medical records of 65 infants with gastroschisis treated at one institution from 1991 to 2000 were available. Infants in group I (prior to December 1998) underwent attempted early repair of the gastroschisis defect on their first day of life. Infants in group II had delayed repair after the initial placement of a preformed silo.Group I had 39 patients; group II had 26 patients. The two groups were equal with respect to maternal age, gestational age, and birth weight. Complete reduction and fascial closure were accomplished for 32 patients (82%) in group I and 25 patients (96%) in group II (P.02). Median time on the ventilator was significantly less for group II (P.0001). Infants in group II had shorter times until first postoperative feeding (P.01) and full feedings (P.006). Group II had fewer complications than group I (23% v 56%; P.01). There appeared to be less necrotizing enterocolitis in group II. The average length of hospital stay was 14 days less for group II.The use of a preformed silo initially followed by delayed fascial closure in infants with gastroschisis is associated with improved fascial closure rates, fewer ventilator days, more rapid return of bowel function, and fewer complications compared with attempts at initial early repair. |
| Databáze: | OpenAIRE |
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