Does staged closure have a worse prognosis in gastroschisis?

Authors

  • Augusto Frederico Schmidt State University of Campinas; School of Medical Sciences; Department of Surgery
  • Anderson Gonçalves State University of Campinas; School of Medical Sciences; Department of Surgery
  • Joaquim Murray Bustorff-Silva State University of Campinas; School of Medical Sciences; Department of Surgery
  • Antônio Gonçalves Oliveira Filho State University of Campinas; School of Medical Sciences; Department of Surgery
  • Sergio Tadeu Marba State University of Campinas; School of Medical Sciences; Department of Pediatrics
  • Lourenco Sbragia University of São Paulo; Ribeirão Preto School of Medicine; Department of Surgery and Anatomy

DOI:

https://doi.org/10.1590/S1807-59322011000400007

Keywords:

Newborn diseases, Gastroschisis, Abdominal wall, Surgical procedures, Operative, Postoperative complications

Abstract

INTRODUCTION: Correction of gastroschisis can be accomplished by primary or staged closure. There is, however, no consensus regarding the best approach or criteria to favor one method over the other has been established. OBJECTIVE: To compare the outcome of primary and staged closure in newborns with gastroschisis using intravesical pressure (IVP) as the decision criterion. PATIENTS & METHODS: We prospectively analyzed 45 newborns with gastroschisis. An IVP with a threshold of 20 cm H2O was used to indicate primary or staged closure, and the outcomes between the two methods were compared. RESULTS AND DISCUSSION: Newborns in whom primary closure was feasible were born at a lower gestational age. There was no significant difference in the frequency of complications, time to begin oral feeding, length of parenteral nutrition or length of hospital stay. Compared with previous reports, our data showed higher rates of prenatal diagnosis and cesarean delivery, a lower average birth weight, a higher rate of small gestational age babies and a more frequent association with intestinal atresia. Conversely, our data showed a lower rate of postoperative necrotizing enterocolitis and a lower average length of hospital stay. CONCLUSION: No significant difference was observed in the outcome of newborns who underwent primary closure or staged closure of gastroschisis when using an IVP below 20 cm H2O as the criterion for primary closure.

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Published

2011-01-01

Issue

Section

Clinical Sciences

How to Cite

Schmidt, A. F., Gonçalves, A., Bustorff-Silva, J. M., Oliveira Filho, A. G., Marba, S. T., & Sbragia, L. (2011). Does staged closure have a worse prognosis in gastroschisis? . Clinics, 66(4), 563-566. https://doi.org/10.1590/S1807-59322011000400007