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[Gastroschisis and omphalocele: factors affecting prognosis (author's transl)]
Insights
Neonatal surgical outcomes for omphalocele and gastroschisis improved significantly over a decade. Advances in parenteral nutrition and reduced relaparotomies contributed to better survival rates in these complex congenital conditions.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Congenital Malformations
Context:
- Omphalocele and gastroschisis are significant congenital abdominal wall defects.
- Surgical management of these conditions presents challenges in neonates.
- Outcomes have historically been associated with high mortality rates.
Purpose:
- To analyze surgical outcomes for neonates with omphalocele and gastroschisis.
- To identify factors influencing mortality and survival rates over a 10-year period.
- To evaluate changes in patient prognosis over time.
Summary:
- A total of 47 newborns (24 omphalocele, 23 gastroschisis) underwent surgery between 1971 and 1981.
- Initial mortality was high (41% omphalocele, 61% gastroschisis).
- Overall mortality decreased from 77% to 28% in the latter half of the study period, linked to improved parenteral nutrition and fewer relaparotomies, despite unchanged surgical techniques.
Impact:
- Demonstrates a significant reduction in mortality for neonatal surgical interventions.
- Highlights the critical role of supportive care, specifically parenteral nutrition and minimizing re-operations, in improving outcomes.
- Provides valuable data for optimizing treatment protocols for gastroschisis and omphalocele.
Abstract:
24 newborns with omphalocele and 23 with gastroschisis were operated upon in the 10-year period from 1971 to 1981. Mortality was 41% in omphaloceles and 61% in gastroschisis. The mortality of all cases dropped from 77% in the first 5-year period to 28% in the second half of the series. While the operative techniques remained unchanged, the better prognosis of the latter group is associated with better parenteral nutrition and fewer relaparotomies.