Does time to theater matter in simple gastroschisis?

Area of Science:

• Neonatal surgery
• Pediatric surgery
• Gastrointestinal surgery

Background:

• Gastroschisis is a congenital defect requiring surgical intervention.
• Previous studies suggested expedited surgical management improves outcomes.
• The impact of timing of initial treatment on length of stay (LOS) requires further investigation.

Purpose of the Study:

• To evaluate the association between the time to first management and the length of stay (LOS) in neonates with gastroschisis.
• To identify factors influencing LOS in gastroschisis management.

Main Methods:

• Retrospective analysis of 86 neonates with gastroschisis admitted between August 2013 and August 2020.
• Exclusion of neonates with complex gastroschisis or undocumented time to first management.
• Linear regression analysis to assess the impact of time to first management, time to first feed, and closure type on LOS, time to full feeds, and time on parenteral nutrition (PN).

Main Results:

• No significant relationship was found between time to first management and LOS (p=0.82).
• Primary closure resulted in a median LOS of 21 days, compared to 59 days for delayed closure with silo placement.
• Delayed first feeds were consistently associated with longer LOS and increased duration of PN.

Conclusions:

• Time to first surgical management in gastroschisis was not associated with changes in LOS.
• Delayed initiation of feeding significantly prolonged LOS and PN duration.
• Prospective studies are recommended to confirm the impact of optimizing feeding protocols on LOS.