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Outcomes of surgically treated babies with gastroschisis – a 10-year experience
  1. P Chandra1,
  2. SV Rasiah1,
  3. A Lander2,
  4. A Tonks3,
  5. MD Kilby1,4,
  6. AK Ewer1,4
  1. 1Birmingham Women's Foundation NHS Trust, Birmingham, UK
  2. 2Birmingham Children's Foundation NHS Trust, Birmingham, UK
  3. 3West Midlands Perinatal Institute, Birmingham, UK
  4. 4Birmingham University, Birmingham, UK

Abstract

Background Gastroschisis is now a common anomaly and survival rates are high, but there is a spectrum of outcomes.

Aim To define the outcomes to discharge of babies treated for gastroschisis over a 10-year period.

Methods All babies born with gastroschisis and treated at the regional surgical unit between 1 January 1998 and 31 December 2007 were identified and data obtained from case notes.

Results 128 babies had gastroschisis, one of four with inadequate data died. Complete data were available in 124 (97%). Median (range) gestation was 37 weeks (31–40), birth weight was 2300 g (1400–4000) and maternal age 20 years (16–35). Primary closure was performed in 70 (57%) babies, 31 (25%) had silo reduction with secondary closure and 23 (18%) babies had a Bianchi procedure. Bowel atresia was seen in 6 (5%) and one baby had a perforation. The median age to full feeds was 25 days (12–350) and two babies went home on parenteral nutrition (PN). The babies required a median of 24 days (10–350) of PN. There were 37 episodes of line infection in 27 babies, two developed intestinal failure and liver disease, one requiring liver transplant. Six cases developed obstruction/stricture postsurgery (three following necrotising enterocolitis (NEC)), 15 (12%) babies were diagnosed with NEC. The median age at discharge was 32 days (16–364). There were no significant differences in outcomes between those with and without atresias.

Conclusion 1/128 babies died. The median stay was 32 days but 8 (6%) babies stayed over 6 months, one had liver transplant and two had home PN. This information is important when counselling parents of babies with gastroschisis.

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