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DOI: 10.1055/s-0030-1267977
© Georg Thieme Verlag KG Stuttgart · New York
Factors Affecting the Outcome in Patients with Gastroschisis: How Important Is Immediate Repair?
Publikationsverlauf
received September 26, 2010
accepted after revision October 09, 2010
Publikationsdatum:
22. November 2010 (online)
![](https://www.thieme-connect.de/media/ejps/201102/lookinside/thumbnails/10.1055-s-0030-1267977-1.jpg)
Abstract
Background: Since 30 years, we have attempted to repair gastroschisis as early as possible, often even in the delivery room. We examined 12 recent years of patient records to evaluate the effect of immediate repair and other factors on the outcome of gastroschisis.
Methods: We reviewed the medical records of patients presenting with gastroschisis (87) at the Children's Hospital of Michigan between 1998 and 2009. Data were evaluated specifically to determine the effect of the place of repair [obstetric hospital (“DR”) vs. children's hospital (“OR”)], the time of repair [less than an hour after delivery (“IR”) or more than one hour (“ER”)], and the type of repair [primary fascial repair and skin closure (“PR”) vs. staged repair (“SR”)].
Results: Patients in the PR group were more likely to spend one week or less on MV (66% in PR vs. 11% in SR, p<0.01). Patients in the DR group were more likely to spend 2 weeks or less on TPN, as were patients in the PR group (51% in PR vs. 17% in SR, p<0.01). Patients in the PR group were more likely to stay in hospital for less than 3 weeks, but the IR and ER groups had almost same hospital stay. Major associated anomalies were present in 19 patients (29%). These patients and those with little or no peel tended to outperform those with peel in each of our outcome measures.
Conclusion: Repair immediately after delivery is beneficial in terms of achieving primary closure of the defect, leading to shorter times on assisted ventilation and parenteral nutrition, and shorter hospital stays.
Key words
gastroschisis - abdominal wall defect - outcome
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Correspondence
Dr. Michael D. Klein
Children's Hospital of Michigan
Pediatric Surgery
3901 Beaubien
48201 Detroit
United States
Telefon: +1 313 745 5840
Fax: +1 313 966 7696
eMail: mklein@dmc.org