Abstract：
PURPOSE:Previous single-center studies have reported favorable outcomes when preformed silos (PFS) are used for the staged reduction of gastroschisis. The aim of this study was to assess the frequency and nature of complications associated with PFS in a large population and provide an insight into the practicalities of their routine use. METHODS:A retrospective review was carried out of all cases of gastroschisis managed with PFS in 4 UK neonatal surgical units for a 6-year period. RESULTS:One hundred fifty infants were included, and 139 (92.7%) silos were applied at cot side (no sedation, n = 93). Median silo size was 4 cm, and time of application was 2.5 hours. Enlarging the defect by incision of fascia was required in 17 (11%). Defect closure was performed at a median of 4 days (0-47) with 93 (62%) being at cot side. Methods of closure were adhesive strips/dressings (n = 94), sutures (n = 48), and patch (n = 8). Discoloration of the viscera occurred in 16 (11%), managed successfully by simple methods (change of PFS, aspirating the stomach, or incision of the defect fascia) (n = 8), conversion to operative silo (n = 3), and operative reduction (n = 1). Four required bowel resection. Other complications included missed atresia (n = 5; 3.3%) and nectrotizing enterocolitis (n = 11; 7%). There were 5 deaths in the series (3.3%). CONCLUSIONS:Staged reduction of gastroschisis with PFS is simple, convenient, and safe. The low rates of associated complications and mortality appear favorable when compared to infants managed with more traditional techniques. We recommend that PFS should be used for the routine management of gastroschisis.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Lansdale N,Hill R,Gull-Zamir S,Drewett M,Parkinson E,Davenport M,Sadiq J,Lakhoo K,Marven Sdoi
10.1016/j.jpedsurg.2009.06.006subject
Has Abstractpub_date
2009-11-01 00:00:00pages
2126-9issue
11eissn
0022-3468issn
1531-5037pii
S0022-3468(09)00463-1journal_volume
44pub_type
杂志文章abstract：AIM:The aim of this study was to investigate whether racial disparities in healthcare exist within a New Zealand pediatric surgical outreach service in a high indigenous Māori population. METHODOLOGY:This retrospective study assessed all pediatric surgical procedures performed within a secondary center in New Zealand ...
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abstract：BACKGROUND:Delaying surgery for infants with CDH until they achieve clinical stability is common practice. Stability, however, is inconsistently defined, and many infants fail to reach pre-established criteria. We sought to determine if infants undergoing surgery without meeting pre-established criteria could achieve m...
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journal_title：Journal of pediatric surgery
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journal_title：Journal of pediatric surgery
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