1 Nov 2016Article
Outcome differences between simple and complex gastroschisis
Vesna Marinovic´ 1Maija Lukacˇ 2Maija Lukacˇ 2Zˇeljko Mikovic´ 3Blagoje Grujic´ 1Maja Milicˇkovic´ 4Gordana Samardžija 5Aleksandra Stojanovic´ 1Dalibor Sabbagh 1
Affiliations
Article Info
1 Department of Neonatal Surgery, Institute for mother and child healthcare, Belgrade, Serbia
2 Department of Neonatal Surgery, University children’s hospital, Belgrade, Serbia
3 Obstetric/Gynecology Clinic Narodni Front, University of Belgrade, Belgrade, Serbia
4 Department of Abdominal Surgery, Institute for mother and child healthcare, Belgrade, Serbia
5 Department of Pathology, Institute for mother and child healthcare, Belgrade, Serbia
Ann. Ital. Chir., 2016, 87(6), 525-530;
Published: 1 Nov 2016
Copyright © 2016 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
BACKGROUND: We reviewed differences of the outcome of newborn with simple and complex gastroschisis treated at our institution over the past fifteen years. METHODS: A retrospective cohort study was performed on all infants with gastroschisis treated at the Institute for mother and child health care, Belgrade, between 2001 and 2015 (n=70). Premature infants (<34 weeks of gestation) and babies with birth weight less than 1500 g were excluded (n=5). We compared outcomes in infants with simple gastroschisis and those with complex gastroschisis. An outcome analysis was performed for birth weight, gestational age, gender, mode of defect closure, presence of intestinal necrosis or perforation, reoperation, duration of mechanical ventilation and total parenteral nutrition, presence of bowel pseudoopstraction, sepsis, total duration of hospital stay, mortality rates. RESULTS: Of 65 patients, 15 (23,07%) had complex gastroschisis, including atresia 5 patients (33,3%), ischemic complication 9 patients (60%) and one patient with closing gastroschisis (6,66%). Sixty eight percent underwent primary closure.There was difference between the simple and the complex gastroschisis in duration of mechanical ventilation (P= ,000003), total parenteral nutrition (P= ,000019), bowel pseudoobstruction (P= ,00067), reoperation (P= ,00122), sepsis (P= ,0043), hospital stay (P= ,000198). In the simple gastroschisis group 92% of patients survived to discharge. In the complex gastroschisis group 3 patients died in hospital (P= ,338). CONCLUSIONS: More research should be focused to predict complex gastroschisis and to improve prenatal diagnosis and postnatal management, without a significant increase in morbidity and mortality.
Keywords
- Complex
- Gastroschisis
- Outcomes
- Simple
- Vanishing