Incidence of surgical procedures for gastrointestinal complications after abdominal wall closure in patients with gastroschisis and omphalocele
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In brief
In brief
Retrospective study of 57 patients demonstrates that complex gastroschisis and omphalocele with liver protrusion carry significantly higher risk of secondary gastrointestinal surgery within one year of abdominal wall closure, with bowel obstruction being a key risk factor requiring reoperation in 35.7% of complex gastroschisis cases.
Written by the GCMD Library team from the article.
Abstract
Purpose
This study aims to define the extent of additional surgical procedures after abdominal wall closure (AWC) in patients with gastroschisis (GS) and omphalocele (OC) with special focus on gastrointestinal related operations.
Methods
A retrospective chart review was performed including all operations in GS and OC patients in the first year after AWC (2010–2019). The risk for surgery was calculated using the one-year cumulative incidence (CI).
Results
33 GS patients (18 simple GS, 15 complex) and 24 OC patients (12 without (= OCL), 12 OC patients with liver protrusion (= OCL +)) were eligible for analysis. 43 secondary operations (23 in GS, 20 in OC patients) occurred after a median time of 84 days (16–824) in GS and 114.5 days (12–4368) in OC. Patients with complex versus simple GS had a significantly higher risk of undergoing a secondary operation (one-year CI 64.3% vs. 24.4%; p = 0.05). 86.5% of surgical procedures in complex GS and 36.3% in OCL + were related to gastrointestinal complications. Complex GS had a significantly higher risk for GI-related surgery than simple GS. Bowel obstruction was a risk factor for surgery in complex GS (one-year CI 35.7%).
Conclusion
Complex GS and OCL + patients had the highest risk of undergoing secondary operations, especially those with gastrointestinal complications.