Surgical Management of Congenital Abdominal Wall Defects in Germany: A Population-Based Study and Comparison with Literature Reports.

Introduction  We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports. Patients and Methods  Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment. Results  Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation ( p  = 0.003) and hospitalization ( p  < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study. Conclusion  Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.