Ward reduction of gastroschisis: risk stratification helps optimise the outcome.

Pediatric Surgery International
Kate LeadbeaterRob Feltrin

Abstract

Categorization of gastroschisis into low risk (simple) and high risk (complex) has been reported as an important determinant of outcome. The role of risk categorization in choosing the optimal surgical approach is unreported. This study aims to investigate the role of risk categorization in decision making for ward reduction of gastroschisis. Data on a cohort of 52 consecutive neonates with gastroschisis between 2000 and 2009 were reviewed. A clinical pathway based on risk categorization was implemented in 2004, and children with simple gastroschisis underwent ward reduction and those with complex gastroschisis underwent surgical closure. Thirty-three neonates since 2004 were analysed and compared to the 19 born prior to 2004. Of the 33 children with gastroschisis in the study group, 23 were assessed as simple and underwent ward reduction with 96% survival. Ten had complex gastroschisis and underwent varying surgical procedures. Only six out of ten children (60%) with complex gastroschisis survived in spite of multiple surgical attempts. Risk stratification of gastroschisis at birth helps in choosing optimal surgical management. Ward reduction can be successfully and safely performed in all children with simple gastroschisis. T...Continue Reading

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Citations

Aug 21, 2012·Journal of Pediatric Surgery·Wilson W ChoiRoy M Kimble
May 19, 2012·The Surgical Clinics of North America·Daniel J Ledbetter
Jul 2, 2016·Journal of Pediatric Surgery·Juin Yee KongUNKNOWN New South Wales and Australian Capital Territory Neonatal Intensive Care Units' Data Collection
Jun 3, 2011·Science Translational Medicine·Andrew C Chan

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