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Closure methods in gastroschisis

Mikael Petrosyan1, Anthony D Sandler1

  • 1Children's National Health System, George Washington University Medical Center, United States.

Seminars in Pediatric Surgery
|November 11, 2018
PubMed

Insights

Gastroschisis outcomes have dramatically improved from high mortality to near-certain survival due to advances in parenteral nutrition and surgical techniques. Minimalist surgical approaches are now favored for abdominal wall closure, yielding excellent results.

Area of Science:

  • Neonatal surgery
  • Pediatric surgery
  • Surgical outcomes

Background:

  • Gastroschisis, a congenital abdominal wall defect, historically had a poor prognosis.
  • Parenteral nutrition significantly improved survival rates for affected neonates.

Purpose of the Study:

  • To review the evolution of surgical techniques for gastroschisis management.
  • To discuss the shift towards minimalist surgical approaches for abdominal wall closure.

Main Methods:

  • Literature review of historical and contemporary surgical management strategies for gastroschisis.
  • Analysis of the impact of surgical techniques on patient outcomes.

Main Results:

  • Surgical intervention aims to return eviscerated contents into the abdominal cavity.
  • Optimal technique depends on intestinal status and abdominal domain accommodation.
  • Minimalist surgical approaches, once due to poor prognosis, are now associated with excellent outcomes.

Conclusions:

  • Gastroschisis management has transformed from high mortality to high survival.
  • Modern surgical techniques, including minimalist approaches, are key to successful outcomes.

Keywords:
GastroschisisSiloSurgical techniqueSutured closureSutureless delayed closure

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