Complex gastroschisis: Clinical spectrum and neonatal outcomes at a referral center

Space: StayCurrentMD Author: Pablo Laje, Maria V Fraga, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N. Scott Adzick Published:

Author / Expert

Pablo Laje, Maria V Fraga, William H Peranteau, Holly L Hedrick, Nahla Khalek, Juliana S Gebb, Julie S Moldenhauer, Mark P Johnson, Alan W Flake, N. Scott Adzick

Topic overview

Abstract

Aim of the study

To evaluate the outcomes of neonates with complex gastroschisis (GC), and correlate outcomes with each type of complication.

Methods

Retrospective review of patients with complex GC owing to prenatal and/or postnatal abdominal complications; 2008–2016. Primary outcomes: time to discontinue parenteral nutrition (off-PN), length of stay (LOS) and neonatal survival.

Main results

We treated 58 patients with complex gastroschisis owing to abdominal complications, which were: intestinal necrosis at birth (n=9), intestinal atresia (n=16), medical necrotizing enterocolitis (NEC) (n=15), surgical NEC (n=1), in utero volvulus (n=1), vanishing gastroschisis (n=2), severe intestinal dysmotility (n=1), delayed abdominal closure (n=3), abdominal compartment syndrome (n=2) and hiatal hernia/severe gastroesophageal reflux disease (GERD; n=11). The off-PN time and LOS of the whole group were 92 (35–255) and 119 (42–282) days, significantly longer than those of a demographically equivalent contemporaneous series of 125 patients with uncomplicated gastroschisis (off-PN 32 [12–105] days [p

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