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Late surgical problems in children born with abdominal wall defects
1Department of Paediatric Surgery, University Hospital, Lund, Sweden.
Insights
This study evaluated long-term surgical issues in 44 children with abdominal wall defects, including omphalocele and gastroschisis. Most patients experienced good long-term outcomes, with correctable late complications.
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Gastroenterology
Background:
- Abdominal wall defects, such as omphalocele and gastroschisis, are congenital conditions requiring surgical intervention.
- Understanding the long-term sequelae of these conditions is crucial for comprehensive patient care.
Purpose of the Study:
- To investigate the prevalence and nature of late surgical problems in patients treated for abdominal wall defects.
- To assess the long-term outcomes and quality of life following surgical repair of omphalocele and gastroschisis.
Main Methods:
- A retrospective review of 55 patients treated for abdominal wall defects over 17 years.
- A questionnaire was sent to parents of surviving children to gather information on late surgical issues, with a 94% response rate.
- Mean follow-up duration was 5.4 years.
Main Results:
- No significant late problems were reported in a substantial proportion of both omphalocele (16/28) and gastroschisis (10/16) patients.
- Common late complications included incisional hernias (7 omphalocele, 6 gastroschisis), intestinal stoma issues (2 patients), and intestinal obstruction (5 patients).
- Other reported issues included abdominal pain, cryptorchidism, and constipation. No significant difference in outcomes was observed between different closure techniques.
Conclusions:
- While late complications can occur following surgical repair of abdominal wall defects, they are often correctable.
- The long-term results for both omphalocele and gastroschisis are generally good, with most patients achieving positive outcomes.
Abstract:
During a 17 year period 55 patients with abdominal wall defects were treated. A questionnaire concerning late surgical problems was distributed to the parents of the 47 surviving children and 44 (94%) answers were received. The mean follow up time was 5.4 years. There was no mention of remaining problems regarding 16 of the 28 omphalocoele patients and 10 of the 16 gastroschisis patients. Postoperative abdominal wall hernia was reported in 7 cases with omphalocoele and in 6 with gastroschisis; postoperative intestinal stoma occurred in 1 child with omphalocoele associated with anal atresia, and in 1 with gastroschisis and postoperative intestinal obstruction in 4 cases with omphalocoele and in 1 with gastroschisis. The other complaints related to abdominal pain, cryptorchidism, constipation and difficulties with care of the intestinal stoma. No difference in results was found between the two types of closure of the abdominal wall defects irrespective of the primary treatment. All the remaining problems could be corrected and the long term results in both conditions were good.