Document Detail


Improved outcomes in the treatment of gastroschisis using a preformed silo and delayed repair approach.
MedLine Citation:
PMID:  12632367     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: The aim of this study was to critically evaluate the clinical outcomes of two different surgical treatment approaches for infants born with gastroschisis. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Authors:
Marc Schlatter; Kristen Norris; Neal Uitvlugt; James DeCou; Robert Connors
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Review    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  38     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-03-12     Completed Date:  2003-11-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  459-64; discussion 459-64     Citation Subset:  IM    
Copyright Information:
Copyright 2003, Elsevier Science (USA). All rights reserved.
Affiliation:
DeVos Children's Hospital, Grand Rapids, Michigan 49503, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Delivery, Obstetric
Enterocolitis, Necrotizing / epidemiology,  etiology,  prevention & control
Fascia / surgery
Female
Gastroschisis / complications,  surgery*
Gestational Age
Humans
Infant, Newborn
Length of Stay
Male
Maternal Age
Parenteral Nutrition, Total / utilization
Postoperative Complications / epidemiology,  etiology,  prevention & control
Pregnancy
Prostheses and Implants
Respiration, Artificial / utilization
Retrospective Studies
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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