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Gastroschisis and omphalocele
1Department of Paediatric Surgery, All India Institute of Medical Sciences, New Delhi.
Indian Journal of Pediatrics
|May 8, 2000
Summary
Primary closure of abdominal wall defects improves survival rates and reduces hospital stays for patients with gastroschisis and omphalocele. Long-term outcomes are generally good, though gastroesophageal reflux (GER) is common.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Abnormalities
Background:
- Survival rates for abdominal wall defects have improved due to advancements in treatment.
- Gastroschisis and omphalocele are common congenital conditions requiring surgical intervention.
Purpose of the Study:
- To review treatment modalities for abdominal wall defects.
- To analyze the long-term outcomes of patients with gastroschisis and omphalocele.
- To compare primary closure with the silo technique for abdominal wall defects.
Main Methods:
- Meta-analysis of English clinical studies from 1953-1998.
- Searched Medline for "abdominal wall defects", "gastroschisis", and "omphalocele or exomphalos".
Main Results:
- Primary closure, when feasible without compromise, leads to better survival rates, lower sepsis risk, and shorter hospital stays.
- No significant differences were observed in oral feeding resumption, parenteral nutrition duration, or ventilatory support between primary and silo techniques.
- Long-term outcomes are generally favorable, with a high incidence of gastroesophageal reflux (GER) noted.
Conclusions:
- Primary closure is the preferred operative management for abdominal wall defects when hemodynamically stable.
- Patients require regular follow-up due to the high prevalence of GER.
- Advances in treatment have significantly improved patient outcomes for these congenital defects.