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Predictive factors at birth of the severity of gastroschisis
Anthony S de Buys Roessingh1, Amélie Damphousse1, Pierluigi Ballabeni1
1Anthony S de Buys Roessingh, Sarah Bouchard, Department of Pediatric Surgery, University Hospital, Hôpital Sainte-Justine, H3T1C5 Montréal, Canada.
Aim:
To establish children born with gastroschisis (GS).
Methods:
We performed a retrospective study covering the period from January 2000 to December 2007. The following variables were analyzed for each child: Weight, sex, apgar, perforations, atresia, volvulus, bowel lenght, subjective description of perivisceritis, duration of parenteral nutrition, first nasogastric milk feeding, total milk feeding, necrotizing enterocolitis, average period of hospitalization and mortality. For statistical analysis, descriptive data are reported as mean ± standard deviation and median (range). The non parametric test of Mann-Whitney was used. The threshold for statistical significance was P < 0.05 (Two-Tailed).
Results:
Sixty-eight cases of GS were studied. We found nine cases of perforations, eight of volvulus, 12 of atresia and 49 children with subjective description of perivisceritis (72%). The mortality rate was 12% (eight deaths). Average duration of total parenteral nutrition was 56.7 d (8-950; median: 22), with five cases of necrotizing enterocolitis. Average length of hospitalization for 60 of our patients was 54.7 d (2-370; median: 25.5). The presence of intestinal atresia was the only factor correlated with prolonged parenteral nutrition, delayed total oral milk feeding and longer hospitalization.
Conclusion:
In our study, intestinal atresia was our predictive factor of the severity of GS.
