Bowel-defect disproportion in gastroschisis: does the need to extend the fascial defect predict outcome?

Pediatric Surgery International
Arash SafaviSonia Butterworth

Abstract

Validated outcome prediction for gastroschisis (GS) permits early risk stratification. The aim of our study was to determine whether the need for GS defect extension: (a) correlates with bowel injury severity at birth, and (b) predicts outcome. A national dataset was used to study GS babies born between 2005 and 2010. The primary outcome was days of parenteral nutrition (PN). Outcomes were analyzed according to the need for fascial extension to facilitate closure or silo placement as follows: Group 1, no extension; Group 2A, extension <2 cm; Group 2B, extension >2 cm. Univariate and where appropriate, multivariate analyses were used. Of 507 cases, 402 had complete defect extension data: Group 1, 297 (73%); Group 2A, 67 (17%); Group 2B, 42 (10%). Group 2B patients had higher rates of atresia, perforation and severe matting (P = 0.001) and required more days on PN compared to Group 1 (63.0 ± 100.4 vs. 39.7 ± 44.5 days: CI 1.2-45.1; P = 0.03). Multivariate analysis revealed that the presence of atresia (P = 0.01) and surgical site (P = 0.001) or bloodstream (P = 0.001) infections were predictive of prolonged PN; however, the need for fascial extension was not. GS newborns who require fascial extension are more likely to have compl...Continue Reading

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Citations

Feb 9, 2018·Expert Review of Gastroenterology & Hepatology·Candace Haddock, Erik D Skarsgard
Dec 13, 2016·Scientific Reports·Benjamin Saul Raywood AllinMarian Knight
Mar 15, 2016·Current Opinion in Pediatrics·Erik D Skarsgard

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