Functional, motor developmental, and long-term outcome after the component separation technique in children with
Floortje C van Eijck1, Leo A van Vlimmeren, René M H Wijnen
1Department of Pediatric Surgery, Erasmus MC Sophia Children's Hospital, PO Box 2060, 3000 CB Rotterdam, the Netherlands. fcvaneijck@gmail.com
Insights
Children treated for giant omphalocele (GOC) using the Component Separation Technique (CST) demonstrated normal abdominal muscle thickness and motor function at long-term follow-up. This suggests CST is a promising surgical approach for GOC.
Area of Science:
- Pediatric Surgery
- Developmental Pediatrics
- Abdominal Wall Reconstruction
Background:
- Giant omphalocele (GOC) presents significant challenges in abdominal wall closure.
- The Component Separation Technique (CST) is a surgical method for complex abdominal wall reconstruction.
Purpose of the Study:
- To assess long-term functional and motor development in children who underwent GOC repair with CST.
- To evaluate abdominal muscle quantity and quality after CST repair for GOC.
Main Methods:
- A cohort of 11 infants with GOC treated with CST between 2004-2007 was evaluated.
- Abdominal wall ultrasound, Movement Assessment Battery for Children (2nd Edition) (M-ABC-2), and physical examinations were performed.
- Functional outcomes were compared to age-matched controls.
Main Results:
- At a mean follow-up of 54 months, ultrasound revealed normal abdominal wall muscle thickness.
- Motor development (M-ABC-2) and stature were within normal limits, comparable to controls.
- Rectus diastasis was observed in 7/8 children, without abdominal protrusion.
Conclusions:
- Children treated with CST for GOC exhibit normal abdominal muscle development and motor function long-term.
- Rectus diastasis is a common finding but does not appear to impede functional outcomes.
- CST is a viable and promising technique for managing giant omphalocele.
Background/Purpose:
The objective of this study was to evaluate the long-term functional and motor development and abdominal muscle quantity in children operated on for giant omphalocele (GOC) with the Component Separation Technique (CST).
Methods:
Between 2004 and 2007, CST was applied in eleven consecutive infants with GOC. Eight underwent ultrasound of the abdominal wall and muscles, assessment of functional and motor development using the Movement Assessment Battery for Children, 2nd Edition (M-ABC-2), and an observational physical examination focused on possible abnormalities in stature and movements related to GOC. Findings were compared with those in age-matched controls. The parents filled in a questionnaire on the children's functioning in daily life.
Results:
The mean age at evaluation was 71 months (range, 42-141 months) with a median time of follow-up of 54 months (range, 38-84 months). Ultrasound of the abdominal wall muscles showed normal muscle thickness. In seven of the eight children, a rectus diastasis was seen without any protrusion. The MABC-2 was within the normal range, and stature and motor coordination did not differ from those in controls.
Conclusions:
After 4.5 years, these children show normal thickness of all abdominal wall muscles and motor function within the normal range, despite a rectus diastasis. The CST seems to be a promising closure technique for GOC.