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Gastroschisis and intestinal atresia
1Department of Surgery, Children's Hospital of Los Angeles, CA.
Journal of Pediatric Surgery
|July 1, 1991
Summary
Treating gastroschisis with intestinal atresia is challenging. A delayed repair approach, allowing bowel recovery before anastomosis, shows promise for reducing infant mortality and morbidity.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Gastrointestinal surgery
Background:
- Gastroschisis with intestinal atresia presents a high mortality rate.
- Optimal surgical management remains controversial.
- This study evaluates an alternative treatment strategy.
Observation:
- Four neonates with gastroschisis and intestinal atresia were treated over 17 years.
- Intestinal atresia varied from single to multiple segments.
- A delayed repair strategy was employed in three patients.
Findings:
- Three patients underwent delayed bowel anastomosis after initial abdominal replacement.
- One patient with jejunal dilatation was treated with a Mikulicz fistula.
- All four patients survived the neonatal period; one died at 1 year from complications of total parenteral nutrition.
Implications:
- A delayed surgical approach may reduce morbidity and mortality in gastroschisis with intestinal atresia.
- This strategy allows for healthier bowel tissue, facilitating easier and more secure anastomoses.
- Further research is warranted to validate this approach in a larger cohort.