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Surgical Management of Congenital Abdominal Wall Defects in Germany: A Population-Based Study and Comparison with
Carmen Dingemann1, Janine Dietrich2, Jan Zeidler2
1Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Insights
Infants with congenital abdominal wall defects (CAWDs) in Germany show excellent surgical outcomes, with no significant difference in complications regardless of closure method. Primary closure for gastroschisis reduced ventilation and hospitalization times.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Public Health
Background:
- Congenital abdominal wall defects (CAWDs) require specialized surgical management.
- Limited data exist on the characteristics, treatment, and outcomes of CAWDs in Germany.
- This study provides a comprehensive analysis of CAWD management in a large German cohort.
Purpose of the Study:
- To analyze the characteristics, treatment modalities, and outcomes of infants with CAWDs in Germany.
- To compare German CAWD treatment results with existing international literature.
- To evaluate the impact of surgical approach on complication rates and patient outcomes.
Main Methods:
- Retrospective analysis of health insurance data covering 10% of the German population.
- Inclusion of patients who underwent CAWD closure over nearly 6 years.
- Categorization of surgical approaches into primary versus secondary closure and definition of complications as reintervention within one year.
Main Results:
- No mortality was observed in patients with gastroschisis or omphalocele.
- Surgical approach (primary vs. secondary closure) did not significantly impact complication rates for either condition.
- Primary closure in gastroschisis was associated with shorter ventilation and hospitalization durations.
- Management modality did not affect ventilation or hospitalization in omphalocele cases.
Conclusions:
- Surgical management of newborns with CAWDs in Germany is of excellent quality.
- No correlation exists between the method of closure and complication rates in gastroschisis and omphalocele.
- The findings support the effectiveness of current surgical practices for CAWDs in Germany.
Abstract:
Introduction We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports. Patients and Methods Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment. Results Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p = 0.003) and hospitalization (p < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study. Conclusion Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.
