Closing arguments for gastroschisis: management with silo reduction
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Bill Chiu
Abstract
Background: There are two approaches to close gastroschisis. Primary closure (PC) is reduction and fascial closure; silo closure (SC) places viscera in a preformed-silo and reduces the contents over time. We have shifted from PC to SC. This study compared the outcomes of these two techniques.
Methods: Records of babies with gastroschisis from 1994–2004 were reviewed. Closure type, ventilator days, days to full-feeds, hospital days, complications, and mortality were recorded.
Results: Twenty-eight patients underwent PC; 20 patients had SC. Differences in ventilator days, days to full-feeds, and hospital days were not statistically significant. Nine PC patients developed closure-related complications vs. none in SC (P<0.05). Eight PC vs. two SC patients had non-closure-related complications (P<0.05). Four PC vs. zero SC patients developed necrotizing enterocolitis (P<0.05). Five PC vs. one SC patients had ventral hernia (P<0.05). No patient died.
Conclusion: PC resulted in higher incidence of reclosure, non-closure-related complications, and necrotizing enterocolitis. Consequently, we recommend SC as the preferred treatment.
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Artikel in diesem Heft
- The chemical erosion of human health: adverse environmental exposure and in-utero pollution – determinants of congenital disorders and chronic disease
- Cesarean section in term breech presentations: do rates of adverse neonatal outcomes differ by hospital birth volume?
- Antibiotic therapy for preterm premature rupture of membranes – results of a multicenter study
- Relation between grief and subsequent pregnancy status 13 months after perinatal bereavement
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Vaginal birth after cesarean section: X-ray pelvimetry at term is informative
- Dilatation of the abdominal umbilical vein is associated with increased risk of thrombotic complications
- Retrospective diagnosis of hypoxic myocardial injury in premature newborns
- Fetal brain injury in experimental intrauterine asphyxia and inflammation in Göttingen minipigs
- Intrauterine growth restriction induces increased capillary density and accelerated type I fiber maturation in newborn pig skeletal muscles
- Closing arguments for gastroschisis: management with silo reduction
- Mean platelet and red blood cell volume measurements to estimate the severity of hypertension in pregnancy
- Torsion of a pedunculated accessory hepatic lobe: differential diagnosis of projectile vomiting in a neonate
- Massive fetomaternal hemorrhage following failed external cephalic version: case report
- Resolution of peripheral tissue ischemia secondary to arterial vasospasm following treatment with a topical nitroglycerin device in two newborns: case reports
- Echocardiography and N-terminal pro BNP
- Frontal-dominant white matter lesions following congenital rubella and cytomegalovirus infection
- Perinatal Programming
- Congress Calendar
