Decentralized surgery of abdominal wall defects in Germany
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Read the article on link.springer.com ↗Article · Mar 2020 · 1 min read
In brief
In brief
Analysis of 513 German newborns with abdominal wall defects (2009-2013) demonstrates that decentralized surgical care achieves mortality rates comparable to international benchmarks: 4% for gastroschisis and 16% for omphalocele. Key risk factors include low birth weight, complex anatomy, and associated anomalies.
Written by the GCMD Library team from the article.
Abstract
Purpose
Neonatal surgery for abdominal wall defects is not performed in a centralized manner in Germany. The aim of this study was to investigate whether treatment for abdominal wall defects in Germany is equally effective compared to international results despite the decentralized care.
Methods
All newborn patients who were clients of the major statutory health insurance company in Germany between 2009 and 2013 and who had a diagnosis of gastroschisis or omphalocele were included. Mortality during the first year of life was analysed.
Results
The 316 patients with gastroschisis were classified as simple (82%) or complex (18%) cases. The main associated anomalies in the 197 patients with omphalocele were trisomy 18/21 (8%), cardiac anomalies (32%) and anomalies of the urinary tract (10%). Overall mortality was 4% for gastroschisis and 16% for omphalocele. Significant factors for non-survival were birth weight below 1500 g for both groups, complex gastroschisis, volvulus and anomalies of the blood supply to the intestine in gastroschisis, and female gender, trisomy 18/21 and lung hypoplasia in omphalocele.
Conclusions
Despite the fact that paediatric surgical care is organized in a decentralized manner in Germany, the mortality rates for gastroschisis and omphalocele are equal to those reported in international data.