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Staged reduction of gastroschisis using preformed silos: practicalities and problems
Nick Lansdale1, Richard Hill, Sobbia Gull-Zamir
1Pediatric Surgical Unit, Sheffield Children's Hospital, Sheffield, United Kingdom.
Journal of Pediatric Surgery
|December 1, 2009
Summary
Preformed silos (PFS) offer a safe and effective method for staged reduction of gastroschisis. This large study shows low complication rates, supporting routine use in neonates.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital anomalies
Background:
- Gastroschisis is a congenital defect requiring surgical intervention.
- Staged reduction techniques are employed for managing abdominal wall defects.
- Preformed silos (PFS) have shown promise in single-center studies.
Purpose of the Study:
- To evaluate the frequency and nature of complications associated with PFS in gastroschisis.
- To assess the practicality of routine PFS use in a large patient cohort.
- To compare outcomes of PFS with traditional gastroschisis management.
Main Methods:
- Retrospective review of gastroschisis cases managed with PFS.
- Data collected from four UK neonatal surgical units over six years.
- Analysis of silo application, defect closure, and associated complications.
Main Results:
- 150 infants with gastroschisis were included; 139 PFS applied at cot side.
- 11% required defect enlargement; 62% of closures were at cot side.
- Complications included visceral discoloration (11%), missed atresia (3.3%), and necrotizing enterocolitis (7%); mortality was 3.3%.
Conclusions:
- Staged reduction of gastroschisis using PFS is a simple, convenient, and safe procedure.
- Low complication and mortality rates suggest PFS is favorable compared to traditional methods.
- Routine use of PFS for gastroschisis management is recommended.