Related Experiment Videos
Gastroschisis: ward reduction compared with traditional reduction under general anesthesia
Mark W Davies1, Roy M Kimble, David W Cartwright
1Grantley Stable Neonatal Unit, Royal Women's Hospital, Brisbane, Queensland, 4029, Australia. Mark_Davies@health.qld.gov.au
Journal of Pediatric Surgery
|March 29, 2005
Summary
Ward reduction for gastroschisis avoids general anesthesia and ventilation, leading to shorter hospital stays. This method shows improved outcomes for infants with gastroschisis.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital anomalies
Background:
- Gastroschisis management traditionally involves surgery under general anesthesia.
- An alternative approach, ward reduction, aims to reduce gut without intubation or general anesthesia.
Purpose of the Study:
- To evaluate if ward reduction decreases morbidity and treatment duration in gastroschisis infants.
- To compare outcomes between operating theatre (OT) reduction and ward reduction (WR) groups.
Main Methods:
- Retrospective analysis of infants with gastroschisis from 1995-2001.
- Comparison of infants managed with OT reduction (pre-Sept 1999) versus WR (post-Sept 1999).
- Eligibility criteria for WR included absence of need for general anesthesia/ventilation.
Main Results:
- 62% of WR infants avoided ventilation and 81% avoided general anesthesia compared to 0% in the OT group.
- WR group showed significantly shorter durations of ventilation and oxygen therapy.
- Infants undergoing WR had earlier intensive care discharge and hospital discharge, and tended towards earlier full enteral feeds.
Conclusions:
- Ward reduction is associated with better outcomes in gastroschisis, including avoidance of general anesthesia/ventilation and earlier discharge.
- A randomized controlled trial comparing ward reduction and operating theatre reduction is feasible and recommended.