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By Alejandro Peñarrieta Daher Residente de Cirugía Pediatrica en Hospital Infantil de México Federico Gómez
Patrick C Bonasso, Brandon Lucke-Wold, Gerald R Hobbs, Richard A Vaughan, Nicholas A Shorter, Don K Nakayama
Careful fluid management is a cornerstone of neonatology because the cardiovascular, respiratory, and gastrointestinal systems in the newborn are sensitive to overhydration. Fluid management in gastroschisis is complicated by insensible fluid loss and postoperative third-space fluid shifts. Study of perioperative fluid management in gastroschisis is limited and has not undergone careful scrutiny. We reviewed perioperative fluid administration and urine output in all infants with gastroschisis over a 5-year period...
August 2016: American Surgeon
Tarun Kumar, Richard Vaughan, Mark Polak
Infants born with gastroschisis in association with intestinal atresia are well described. We are the proposing the classification of vanishing gastroschisis. In this series of six cases, at one end of the spectrum is an infant having gastroschisis with a much narrower defect on the right side of umbilicus. The ischemic bowel loops were connected to bowel inside the abdomen by a fibrous band compressing the exposed bowel mesentery. On the other end of spectrum, an infant having extensive bowel atresia and complete closure of abdominal wall defect (gastroschisis) detected on antenatal ultrasound...
February 2013: European Journal of Pediatric Surgery
B A Khalil, J C Gillham, L Foresythe, R Harding, T Johnston, C Wright, A Morabito
Vanishing gastroschisis is a rare in utero complication of gastroschisis. It is associated with a high mortality. We present a case report of an infant with vanishing gastroschisis that was managed with a combination of reconstructive bowel surgery and hepatosparing parenteral nutrition. The technique is described and a review of the literature is provided.
July 2010: Annals of the Royal College of Surgeons of England
Julio Nazer Herrera, Lucas Karachon Essedin, Lucía Cifuentes Ovalle, Rodrigo Assar Cuevas
INTRODUCTION: Several communications have reported a significant increase in the prevalence of gastroschisis at birth in the last three decades. In many Countries it is referred to as "a pandemic strongly associated to low maternal age". OBJECTIVE: To verify if there has been a significant increase in the prevalence of gastroschisis at birth in Chile, and if this rate is associated with a low maternal age. PATIENTS AND METHODS: The study was performed using the ECLAMC data base from 26 Chilean Hospitals...
July 27, 2016: Revista Chilena de Pediatría
L G C Tullie, G M Bough, A Shalaby, E M Kiely, J I Curry, A Pierro, P De Coppi, K M K Cross
PURPOSE: To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. METHODS: With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007-2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. RESULTS: Fifty-three patients were identified, gestation 36 weeks (31-38), birth weight 2...
August 2016: Pediatric Surgery International
Andrew R Ross, Nigel J Hall
BACKGROUND: Core outcome sets (COS) facilitate clinical research by providing an agreed set of outcomes to be measured when evaluating treatment efficacy. Gastroschisis is increasing in frequency and evidence-based treatments are lacking. We aimed to identify initial candidate outcomes for a gastroschisis COS from existing literature. METHODS: Using a sensitive search strategy we identified randomized controlled trials (RCTs) and systematic reviews (SRs) of treatment interventions for gastroschisis...
August 2016: Journal of Pediatric Surgery
Monika Uribe-Leitz, Courtney E McCracken, Kurt F Heiss, Mark L Wulkan, Mehul V Raval
Objective Outcomes for gastroschisis (GS) remain highly variable and avoiding infectious complications (ICs) may represent a significant improvement opportunity. Our objective was to provide estimates of the impact of IC on length of stay (LOS) and costs. Study Design Using a national database, 1,378 patients with GS were identified. Patient and hospital characteristics were compared and LOS and costs evaluated for patients with and without IC. Results Two-thirds of all GS patients had IC, and IC were common for simple and complex GS (65, 73%, respectively)...
May 30, 2016: American Journal of Perinatology
María Paz Bidondo, Boris Groisman, Juan A Gili, Rosa Liascovich, Pablo Barbero, Verónica Pingray
INTRODUCTION: Congenital anomalies (CAs) account for 26% of infant mortality in Argentina. The lethality rate for CAs measures the risk of death among affected infants. OBJECTIVES: To describe the prevalence at birth of a group of selected CAs, to estimate the neonatal lethality rate, and to examine its association with different variables. POPULATION AND METHODS: The study was conducted using data provided by the National Registry of Congenital Anomalies...
August 2015: Archivos Argentinos de Pediatría
Kat Ford, Dan Poenaru, Olivier Moulot, Kate Tavener, Sarah Bradley, Rouma Bankole, Nyaweleni Tshifularo, Emmanuel Ameh, Nelson Alema, Eric Borgstein, Ann Hickey, Niyi Ade-Ajayi
INTRODUCTION: Economic disadvantage may adversely influence the outcomes of infants with gastroschisis (GS). Gastroschisis International (GiT) is a network of seven paediatric surgical centres, spanning two continents, evaluating GS treatment and outcomes. MATERIAL AND METHODS: A 2-year retrospective review of GS infants at GiT centres. Primary outcome was mortality. Sites were classified into high, middle and low income country (HIC, MIC, and LIC). MIC and LIC were sometimes combined for analysis (LMIC)...
August 2016: Journal of Pediatric Surgery
Fouad Youssef, Li Hsia Alicia Cheong, Sherif Emil
BACKGROUND: Care of infants with gastroschisis is centralized in Canada and noncentralized in the United States. We conducted an outcomes comparison between the two countries and analyzed the determinants of such outcomes. METHODS: Inpatient mortality and hospital stay of gastroschisis patients from the Canadian Pediatric Surgery Network prospective clinical database for the period 2005-2013 were compared with those from the US Kids Inpatient Database for the period 2003-2012...
June 2016: Journal of Pediatric Surgery
Erik D Skarsgard
PURPOSE OF REVIEW: The diagnosis and treatment of gastroschisis spans the perinatal disciplines of maternal fetal medicine, neonatology, and pediatric surgery. Since gastroschisis is one of the commonest and costliest structural birth defects treated in neonatal ICUs, a comprehensive review of its epidemiology, prenatal diagnosis, postnatal treatment, and short and long-term outcomes is both timely and relevant. RECENT FINDINGS: The incidence of gastroschisis has increased dramatically over the past 20 years, leading to a renewed interest in causation...
June 2016: Current Opinion in Pediatrics
Fouad Youssef, Andrew Gorgy, Ghaidaa Arbash, Pramod S Puligandla, Robert J Baird
BACKGROUND: Flap closure represents an alternative to fascial closure for gastroschisis. We performed a systematic review and meta-analysis of outcomes comparing these techniques. METHODS: A registered systematic review ( PROSPERO: CRD42015016745) of comparative studies was performed, querying multiple databases without language or date restrictions. Gray literature was sought. Outcomes analyzed included: mortality, ventilation days, feeding parameters, length of stay (LOS), wound infection, resource utilization, and umbilical hernia incidence...
May 2016: Journal of Pediatric Surgery
Helen Carnaghan, David Baud, Eveline Lapidus-Krol, Greg Ryan, Prakesh S Shah, Agostino Pierro, Simon Eaton
INTRODUCTION: Induced birth of fetuses with gastroschisis from 34weeks gestational age (GA) has been proposed to reduce bowel damage. We aimed to determine the effect of birth timing on time to full enteral feeds (ENT), length of hospital stay (LOS), and sepsis. METHODS: A retrospective analysis (2000-2014) of gastroschisis born at ≥34weeks GA was performed. Associations between birth timing and outcomes were analyzed by Mann-Whitney test, Cox regression, and Fisher's exact test...
May 2016: Journal of Pediatric Surgery
Jennifer L Carpenter, Taylor L Wiebe, Darrell L Cass, Oluyinka O Olutoye, Timothy C Lee
BACKGROUND: The purpose of this study was to quantify quality of life (QOL) outcomes in gastroschisis children using a validated QOL inventory survey. METHODS: A chart review and prospective survey (2012 Pediatric Quality of Life Inventory™ (PedsQL™)) were performed for gastroschisis patients from 2005 to 2011. Demographics and scores were compared between patents with simple versus complicated gastroschisis and patients with and without bowel resection. RESULTS: One hundred nineteen patients (>2years of age) were identified...
May 2016: Journal of Pediatric Surgery
Abbey M Jones, Jennifer Isenburg, Jason L Salemi, Kathryn E Arnold, Cara T Mai, Deepa Aggarwal, William Arias, Gerard E Carrino, Emily Ferrell, Olakunle Folorunso, Brendan Ibe, Russell S Kirby, Heidi R Krapfl, Lisa K Marengo, Bridget S Mosley, Amy E Nance, Paul A Romitti, Joseph Spadafino, Jennifer Stock, Margaret A Honein
Gastroschisis is a serious congenital defect in which the intestines protrude through an opening in the abdominal wall. Gastroschisis requires surgical repair soon after birth and is associated with an increased risk for medical complications and mortality during infancy. Reports from multiple surveillance systems worldwide have documented increasing prevalence of gastroschisis since the 1980s, particularly among younger mothers; however, since publication of a multistate U.S. report that included data through 2005, it is not known whether prevalence has continued to increase...
January 22, 2016: MMWR. Morbidity and Mortality Weekly Report
Brian C Gulack, Matthew M Laughon, Reese H Clark, Terrance Burgess, Sybil Robinson, Abdurrauf Muhammad, Angela Zhang, Adrienne Davis, Robert Morton, Vivian H Chu, Christopher J Arnold, Christoph P Hornik, P Brian Smith
OBJECTIVE: To assess the effect of enteral feeding with human milk on the time from initiation of feeds to discharge after gastroschisis repair through review of a multi-institutional database. STUDY DESIGN: Infants who underwent gastroschisis repair between 1997 and 2012 with data recorded in the Pediatrix Medical Group Clinical Data Warehouse were categorized into 4 groups based on the percentage of days fed human milk out of the number of days fed enterally. Cox proportional hazards regression modeling was performed to determine the adjusted effect of human milk on the time from initiation of feeds to discharge...
March 2016: Journal of Pediatrics
S F Hassan, S Hassan, A Pimpalwar
INTRODUCTION: Primary suture-less closure of gastroschisis using negative pressure dressing (wound vacuum) involves the application of an initial preformed Silo with subsequent bedside suture-less closure of the defect using negative pressure dressing. The advantages of this gentle approach are the simple bedside closure without intubation, paralysis or ventilation as well as reduced risk of barotrauma, abdominal compartment syndrome, acidosis, bowel infarction and necrotizing enterocolitis...
October 2011: European Journal of Pediatric Surgery
M Davenport, S Haugen, A Greenough, K Nicolaides
Four cases of antenatally diagnosed gastroschisis are described in whom there was significant closure of the abdominal wall defect around the prolapsed midgut. In 2 cases this resulted in near-total midgut infarction and short bowel syndrome. In a further case there was entry and exit jejunal and colonic atresia and significant midgut damage but some viability of extrabdominal bowel. In the final case, although there was complete closure of the ring around the base of the midgut, no intestinal loss had occurred...
December 2001: Journal of Pediatric Surgery
Sarah A Vogler, Stephen J Fenton, Eric R Scaife, Linda S Book, Daniel Jackson, Peter F Nichol, Rebecka L Meyers
BACKGROUND: In infants with gastroschisis antenatal closure of the umbilical defect results in a proximal atresia with ischemia and/or volvulus of the extracorporeal midgut. It has been described as "closed gastroschisis" or "vanishing midgut." METHODS: A 10-year review of 219 gastroschisis patients identified 10 infants with this rare complication. RESULTS: In these 10 infants, the extracorporeal midgut was invariably matted and fibrosed...
June 2008: Journal of Pediatric Surgery
Robert Baird, Pramod Puligandla, Erik Skarsgard, Jean-Martin Laberge
BACKGROUND/PURPOSE: Neonates with gastroschisis make up an increasing proportion of prolonged surgical NICU admissions. While infectious complications are known to increase patient morbidity, it is unclear whether they vary according to abdominal closure method, or can be predicted by initial patient assessment. METHODS: A national, prospective, disease-specific database was evaluated for episodes of wound infection (WI) and catheter-related infection (CRI). Antibiotic use and timing, as well as method and location of abdominal closure were studied...
April 2012: Pediatric Surgery International
2015-11-08 14:15:53
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