Relationship between volume and outcome for gastroschisis: a systematic review protocol

Area of Science:

• Pediatric Surgery
• Congenital Anomalies
• Health Services Research

Background:

• Gastroschisis is a congenital anomaly necessitating surgical intervention for intestinal repositioning and abdominal closure.
• Higher hospital or surgeon volume is linked to improved outcomes in various high-risk procedures.
• The relationship between volume and gastroschisis outcomes requires comprehensive investigation.

Purpose of the Study:

• To systematically review the literature on the association between hospital or surgeon volume and clinical outcomes in gastroschisis.
• To synthesize evidence regarding survival, mortality, morbidity, quality of life, and length of stay.
• To provide evidence for informing decision-makers and clinicians on optimizing care for gastroschisis.

Main Methods:

• Systematic literature search across multiple databases (Medline, Embase, CENTRAL, CINAHL, Biosis Previews) and trial registries.
• Inclusion of randomized controlled trials and prospective/retrospective cohort studies.
• Systematic assessment of risk of bias and data extraction, followed by a narrative synthesis without meta-analysis.

Main Results:

• The review will synthesize findings on survival, mortality, and various morbidity measures (e.g., gastrointestinal complications, sepsis).
• Data on quality of life and length of stay will also be extracted and analyzed.
• The certainty of evidence will be assessed using GRADE methodology.

Conclusions:

• This systematic review addresses the need for a comprehensive summary of volume-outcome relationships in gastroschisis.
• Results will guide clinical practice and policy development for managing gastroschisis.
• Evidence generated will support informed decision-making to improve patient outcomes.