Early versus delayed silo closure in gastroschisis: a retrospective study
Pragati Sharma1, Parshotam Gera1, Shripada Rao2,3
1Department of Paediatric Surgery, Perth Children's Hospital, Nedlands, WA, Australia.
Pediatric Surgery International
|May 18, 2025
Summary
Early abdominal wall closure in gastroschisis infants (≤5 days) improved outcomes, reducing time to full feeds and hospital stay compared to delayed closure (>5 days). This approach enhances recovery for neonates with this congenital condition.
Area of Science:
- Neonatal surgery
- Pediatric surgery
- Congenital anomalies
Background:
- Gastroschisis management typically involves gradual reduction of herniated viscera using preformed silos.
- Delayed abdominal wall closure post-silo reduction may increase infant morbidities.
Purpose of the Study:
- To compare outcomes of gastroschisis infants based on abdominal wall closure timing: ≤5 days versus >5 days after birth.
Main Methods:
- Retrospective cohort study including 109 infants managed with primary silo and staged reduction.
- Infants were categorized into early-closure (≤5 days) and delayed-closure (>5 days) groups.
Main Results:
- Early closure (34 infants) showed significantly shorter median age at full feeds (15 days) and hospital stay (19 days) compared to delayed closure (75 infants) (24.5 days and 32 days, respectively).
- Delayed closure and complex gastroschisis were independently associated with longer time to full feeds and hospital stay.
- Mortality rate was low (2.7%) with no significant difference between groups.
Conclusions:
- Gradual silo reduction is effective for gastroschisis.
- Closing the abdominal wall defect within five days may further improve outcomes for neonates with gastroschisis.
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