The contemporary outcome of gastroschisis
| Autor: | J. Bruce, A. Bianchi, A. P. Dickson, C. M. Doig, C. P. Driver, J. Bowen |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Pediatrics Gestational Age Abdominal wall Risk Factors medicine Birth Weight Humans Risk factor Retrospective Studies Gastroschisis business.industry Mortality rate Intestinal atresia Gestational age Infant Retrospective cohort study General Medicine medicine.disease Surgery medicine.anatomical_structure Treatment Outcome Atresia Pediatrics Perinatology and Child Health business |
| Zdroj: | Journal of pediatric surgery. 35(12) |
| ISSN: | 0022-3468 |
| Popis: | Background: The aim of this study was to evaluate the contemporary outcome in the management of gastroschisis. Methods: A retrospective analysis was conducted of 91 babies admitted over a 7-year period to a single neonatal surgical unit with a diagnosis of gastroschisis. Results: An antenatal diagnosis was made in 89 (98%) cases. Surgical intervention occurred in 90 babies, at a mean of 5 hours (range, 0.5 to 17) postdelivery. In 72 (80%) cases, primary closure of the abdominal defect was achieved, with a silo fashioned in the remaining 18 (20%). One child died before abdominal closure. The median time to full oral feeding was 30 days (range, 5 to 160 days), and to discharge was 42 days (range, 11 to 183 days). Those children who required a silo, took longer to feed ( P =.008) and stayed longer in the hospital ( P =.021). The 8 (8.8%) children with an intestinal atresia, required significantly more operative procedures ( P =.0001) and took significantly longer to achieve full oral feeding ( P =.04), but the presence of an atresia was not an independent risk factor for mortality. There were 7 deaths (7.7%), 3 within the first 7 days. Of the deaths, 5 (71%) were caused by overwhelming sepsis. Conclusions: The contemporary mortality rate from gastroschisis is less than 8%, and minimizing septic complications would contribute significantly to reducing this. Strategies designed to improve morbidity must focus on optimizing management of those factors associated with a prolonged recovery, namely intestinal atresia, prematurity, and the use of a silo. J Pediatr Surg 35:1719-1723. Copyright © 2000 by W.B. Saunders Company. |
| Databáze: | OpenAIRE |
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