Gastroschisis Treatment: Evaluation of Surgical Techniques and Results

Abstract

Objective: Recently, achieving good cosmetic results for patients with gastroschisis has gained popularity, as since the visceral organs can be safely positioned into the abdominal cavity. We aimed to evaluate patient outcomes while focusing on the cosmetic results to contribute to the limited amount of data on this subject in the literature.

Methods: From January 2005 to May 2018, patients operated on for gastroschisis in a single institution were evaluated retrospectively.

Results: Twenty-two patients with gastroschisis were treated (10 females/12 males). The mean gestational age was 38.2 +/- 2.1 weeks. The mean birth weight was 2256.9 +/- 418.2 g. Eleven patients were diagnosed prenatally. Five patients had complex gastroschisis. Others presented with necrosis (n=3), perforation (n=3), volvulus (n=1) and jejunal atresia (n=1). Primary closure (n=16) and staged closure (n=6) were performed. Patients needed mechanical ventilation and total parenteral nutrition for 3.7 +/- 1.0 days and 24.3 +/- 9.7 days, respectively. Enteral feeding was started at 15.9 +/- 10.5 days. The duration of hospitalisation was 36.7 +/- 13.3 days. Three patients died from sepsis and multi-organ failure.

Conclusion: We believe that performing appropriate gastroschisis surgery at the same hospital without transferring to another centre is the main factor in achieving a successful outcome. Good cosmetic results and visceral function were achieved in this study in 86.3% patients.