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Technical Considerations and Approach to Redo Foregut Surgery
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Considerations on gastroschisis repair.

S Ionescu1, B Andrei, S Tirlea

  • 1Department of Pediatric Surgery, Marie S. Curie Emergency Children Hospital, Bucharest, Romania. nsionescu@yahoo.com

Chirurgia (Bucharest, Romania : 1990)
|August 21, 2013
PubMed
Summary

This study presents an innovative umbilical cord patch technique for gastroschisis repair when primary closure is not feasible. This method offers excellent outcomes, is cost-effective, and reduces infection risk in infants.

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Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Abdominal Wall Defects

Background:

  • Gastroschisis repair often requires management of large abdominal wall defects.
  • Previous methods for covering eviscerated bowel include skin grafts and dura mater grafts.
  • Primary closure can lead to increased intra-abdominal pressure if the abdominal cavity is hypoplastic.

Purpose of the Study:

  • To introduce an alternative repair method for gastroschisis in cases with disproportionate organ evisceration and a small abdominal cavity.
  • To address the challenge of increased intra-abdominal pressure associated with primary closure in such scenarios.

Main Methods:

  • An alternative repair method utilizing an umbilical cord patch was employed for parietal defects when primary closure was not possible.

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  • The umbilical cord patch creates a mesothelial surface in direct contact with the eviscerated bowel.
  • Main Results:

    • The umbilical cord patch technique demonstrated excellent long-term results in patients.
    • This method facilitates the creation of a biologically compatible surface for bowel contact.

    Conclusions:

    • The umbilical cord patch is an easy-to-apply and effective technique for gastroschisis repair, particularly when primary closure is not achievable.
    • Using autologous umbilical cord offers advantages such as availability, reduced infection rates, and lower costs.