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32 papers 0 to 25 followers
Jean-Luc Michel, Rani Kassir, Luke Harper, Laurent Gavage, Fernanda Frade, Pauline Clermidi, Frederique Sauvat, Duksha Ramful
PURPOSE: To suggest a novel technique for omphalocele closure which uses the circular base of the umbilical cord, thus allowing for a more physiological healing process and natural-looking scar. METHODS: Among 16 neonates operated for omphalocele between 2011 and 2016, 12 were closed with a one-stage procedure using a Z omphaloplasty (ZORRO). Median gestational age was 36.5 weeks; median birth weight was 3210 g. The umbilical arteries were divided and ligated outside the peritoneal cavity above the parietal musculocutaneous plane...
July 2018: Journal of Pediatric Surgery
Rachel M Landisch, Ziyan Yin, Melissa Christensen, Aniko Szabo, Amy J Wagner
BACKGROUND/PURPOSE: Elective preterm delivery (EPD) of a fetus with gastroschisis may prevent demise and ameliorate intestinal injury. While the literature on optimal timing of delivery varies, we hypothesize that a potential benefit may be found with EPD. METHODS: A meta-analysis of publications describing timing of delivery in gastroschisis from 1/1990 to 8/2016 was performed, including studies where either elective preterm delivery (group 1, G1) or preterm gestational age (GA) (group 2, G2) were evaluated against respective comparators...
December 2017: Journal of Pediatric Surgery
Floortje C van Eijck, Rene M H Wijnen, Harry van Goor
BACKGROUND/PURPOSE: Adhesive small bowel obstruction (SBO) is a feared complication after correction of abdominal wall defects in neonates. Knowledge of its incidence and potential risk factors in a well-documented group with strict follow-up is needed to guide preventive measures. METHODS: Records of 170 neonates with abdominal wall defects, 59 gastroschisis (GS) and 111 omphalocele (OC), were reviewed focusing on SBO. Risk of SBO was calculated, and potential risk factors were analyzed...
March 2008: Journal of Pediatric Surgery
Patrick M Chesley, Daniel J Ledbetter, John J Meehan, Assaf P Oron, Patrick J Javid
BACKGROUND: Gastroschisis is a newborn anomaly requiring emergent surgical intervention. We review our experience with gastroschisis to examine trends in contemporary surgical management. METHODS: Infants who underwent initial surgical management of gastroschisis from 1996 to 2014 at a pediatric hospital were reviewed. Closure techniques included primary fascial repair using suture or sutureless umbilical closure, and staged repair using sutured or spring-loaded silo (SLS)...
May 2015: American Journal of Surgery
Alexander M Friedman, Cande V Ananth, Zainab Siddiq, Mary E D'Alton, Jason D Wright
BACKGROUND: Gastroschisis is a severe congenital anomaly the etiology of which is unknown. Research evidence supports attempted vaginal delivery for pregnancies complicated by gastroschisis in the absence of obstetric indications for cesarean delivery. OBJECTIVE: The objectives of the study evaluating pregnancies complicated by gastroschisis were to determine the proportion of women undergoing planned cesarean vs attempted vaginal delivery and to provide up-to-date epidemiology on the risk factors associated with this anomaly...
September 2016: American Journal of Obstetrics and Gynecology
Matias Bruzoni, Joshua D Jaramillo, Jonathan L Dunlap, Claire Abrajano, Shobha W Stack, Susan R Hintz, Tina Hernandez-Boussard, Sanjeev Dutta
BACKGROUND: Sutureless gastroschisis repair involves covering the abdominal wall defect with the umbilical cord or a synthetic dressing to allow closure by secondary intention. No randomized studies have described the outcomes of this technique. Our objective was to prospectively compare short-term outcomes of sutureless vs sutured closure in a randomized fashion. STUDY DESIGN: We recruited patients who presented with gastroschisis between 2009 and 2014 and were randomized into either sutureless or sutured treatment groups...
June 2017: Journal of the American College of Surgeons
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
Alya Al-Kaff, Sarah C MacDonald, Nancy Kent, Jason Burrows, Erik D Skarsgard, Jennifer A Hutcheon
OBJECTIVE: The purpose of this study was to determine the influence of planned mode and planned timing of delivery on neonatal outcomes in infants with gastroschisis. STUDY DESIGN: Data from the Canadian Pediatric Surgery Network cohort were used to identify 519 fetuses with isolated gastroschisis who were delivered at all tertiary-level perinatal centers in Canada from 2005-2013 (n = 16). Neonatal outcomes (including length of stay, duration of total parenteral nutrition, and a composite of perinatal death or prolonged exclusive total parenteral nutrition) were compared according to the 32-week gestation planned mode and timing of delivery with the use of the multivariable quantile and logistic regression...
October 2015: American Journal of Obstetrics and Gynecology
L M Harper, K R Goetzinger, J R Biggio, G A Macones
OBJECTIVE: To determine the most cost-effective timing of delivery in pregnancies complicated by gastroschisis, using a decision-analytic model. METHODS: We created a decision-analytic model to compare planned delivery at 35, 36, 37, 38 and 39 weeks' gestation. Outcomes considered were stillbirth, death within 1 year of birth and respiratory distress syndrome (RDS). Probability estimates of events (stillbirth, complex gastroschisis and RDS for each gestational age at delivery and risk of death with simple and complex gastroschisis), utilities and costs assigned to the outcomes were obtained from the published literature...
August 2015: Ultrasound in Obstetrics & Gynecology
Mary Ashley Cain, Jason L Salemi, Jean Paul Tanner, Mulubrhan F Mogos, Russell S Kirby, Valerie E Whiteman, Hamisu M Salihu
OBJECTIVE: To investigate the association between gestational age at delivery and perinatal outcomes among gastroschisis-affected pregnancies that result in live birth. METHODS: We conducted a retrospective cohort study using a linked maternal-infant database for more than 2.3 million liveborn neonates in Florida from 1998 to 2009. Cases were identified using a combination of International Classification of Diseases, 9th Edition, Clinical Modification, diagnosis and procedure codes indicative of gastroschisis...
September 2014: Obstetrics and Gynecology
Francesco D'Antonio, Calogero Virgone, Giuseppe Rizzo, Asma Khalil, David Baud, Titia E Cohen-Overbeek, Marina Kuleva, Laurent J Salomon, Maria Elena Flacco, Lamberto Manzoli, Stefano Giuliani
BACKGROUND AND OBJECTIVE: Gastroschisis is a congenital anomaly with increasing incidence, easy prenatal diagnosis and extremely variable postnatal outcomes. Our objective was to systematically review the evidence regarding the association between prenatal ultrasound signs (intraabdominal bowel dilatation [IABD], extraabdominal bowel dilatation, gastric dilatation [GD], bowel wall thickness, polyhydramnios, and small for gestational age) and perinatal outcomes in gastroschisis (bowel atresia, intra uterine death, neonatal death, time to full enteral feeding, length of total parenteral nutrition and length of in hospital stay)...
July 2015: Pediatrics
Pramod S Puligandla, Robert Baird, Eric D Skarsgard, Sherif Emil, Jean-Martin Laberge
PURPOSE: The GPS enables risk stratification for gastroschisis and helps discriminate low from high morbidity groups. The purpose of this study was to revalidate GPS's characterization of a high morbidity group and to quantify relationships between the GPS and outcomes. METHODS: With REB approval, complete survivor data from a national gastroschisis registry was collected. GPS bowel injury scoring was revalidated excluding the initial inception/validation cohorts (>2011)...
May 2017: Journal of Pediatric Surgery
Chris Houben, Mark Davenport, Niyi Ade-Ajayi, Nicki Flack, Shailesh Patel
PURPOSE: Gastroschisis (GS) is defined as a full-thickness abdominal wall defect (usually right-sided) with intestinal prolapse and occasionally other viscera. The defect itself may close around the viscera causing exit or entry level intestinal atresia and ischaemia or midgut infarction, previously described as closed GS. We now report the largest series of infants born with various stages of closing GS describing features, management, and outcome. METHODS: The study used a single-centre retrospective review of infants with GS and evidence of defect closure at birth...
February 2009: Journal of Pediatric Surgery
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
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, 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
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
Arash Safavi, Erik D Skarsgard
Gastroschisis (GS) is a structural defect of the anterior abdominal wall, usually diagnosed antenatally, that occurs with a frequency of approximately 4 per 10,000 pregnancies. Babies born with GS require neonatal intensive care and surgical management of the abdominal wall defect soon after birth. Although contemporary survival rates for GS are over 90%, these babies are at risk for significant morbidity, and require 4 to 6 weeks of costly, resource-intensive care in specialized neonatal units. Much consideration has been given to how best to treat the abdominal wall defect of GS...
May 2015: Surgical Technology International
Carmen Mesas Burgos, Anna Svenningsson, Jenny Hammarqvist Vejde, Tina Granholm, Peter Conner
BACKGROUND: The timing and mode of delivery of pregnancies with prenatally diagnosed gastroschisis remains controversial. AIM: To evaluate the outcome of patients with gastroschisis managed during two time periods: 2006-2009 and 2010-2014, with planned elective cesarean delivery at 37 versus 35 gestational weeks (gw). A secondary aim was to analyze the outcome in relation to the gestational age at birth. MATERIAL AND METHODS: Retrospective review of all cases with gastroschisis managed at our institution between 2006 and 2014...
November 2015: Pediatric Surgery International
Dong Luo, Lan Wu, Hai Wu, Wei Huang, Han Huang
Gastroschisis requires surgical repair, which is generally performed after birth. We report a case in which a fetus with gastroschisis underwent the abdominal wall defect repair before birth. To ensure reliable operating conditions for the repair (to prevent fetal movement and crying), the fetus received deep anesthesia via placental transfer of maternally administered anesthetics. Meanwhile, the ex utero intrapartum treatment procedure was performed to ensure fetal oxygen supply, which was likely to be compromised by the deep fetal anesthesia...
2015: International Journal of Clinical and Experimental Medicine
2015-08-12 04:09:14
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