Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas

B. Hannie Eggink, Carol Richardson, Michael Malloy, Carlos A. Angel

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background/Purpose: In the past decade, the preferred method of closure of gastroschisis at our institution has been staged reduction using a silo with repair on an elective basis (SR) rather than primary surgical closure (PC). We performed a 20-year case review of infants with gastroschisis at a university hospital to compare these shifts in management and to determine factors affecting outcome. Methods: Seventy-two cases were reviewed from 1983 to 2003. Times to first and full feeds were outcome variables for statistical analysis. Results: The prevalence of gastroschisis increased from 0.03% to 0.1% since 1983. Patients had low birth weights (mean = 2294 g) and were borderline premature (mean = 35.8 weeks). Only 3% of the infants were African American. There was a high rate of cesarean deliveries (57%). Ten patients (15%) had gastroschisis complicated by liver herniation, intestinal atresia(s), and/or necrosis/perforation. Most patients were managed by SR (67%). Eight percent of the infants died, 9% developed necrotizing enterocolitis, and 50% had other gastrointestinal complications. Twenty-seven percent of the infants managed with SR did not need initial mechanical ventilation. However, the patients who underwent SR were ventilated longer after birth as compared with those who underwent PC (P < .08). Infants with a complicated gastroschisis had significantly longer times to first and full feeds (P < .001). Patients managed with SR took significantly longer to reach full feeds (P = .001), and there was a trend of starting feeds later (P = .06). When patients with a complicated gastroschisis were excluded, the differences between the SR and PC groups were even greater (P = .01; P < .001). Conclusions: In our patient population, the prevalence of gastroschisis increased by more than 400% since 1983. The defect was rare in African-American infants. Management by SR was associated with longer ventilation times and longer times to first and full feeds for both uncomplicated and complicated gastroschisis cases.

Original languageEnglish
Pages (from-to)1103-1108
Number of pages6
JournalJournal of Pediatric Surgery
Volume41
Issue number6
DOIs
StatePublished - Jun 2006

Fingerprint

Gastroschisis
African Americans
Intestinal Atresia
Necrotizing Enterocolitis
Low Birth Weight Infant
Artificial Respiration
Ventilation
Necrosis
Parturition
Liver

Keywords

  • Gastroschisis
  • Gastroschisis repair
  • Outcome analysis

ASJC Scopus subject areas

  • Surgery

Cite this

Outcome of gastroschisis : a 20-year case review of infants with gastroschisis born in Galveston, Texas. / Eggink, B. Hannie; Richardson, Carol; Malloy, Michael; Angel, Carlos A.

In: Journal of Pediatric Surgery, Vol. 41, No. 6, 06.2006, p. 1103-1108.

Research output: Contribution to journalArticle

@article{6b1aa0d602514075bbb4cbba5c35a9f0,
title = "Outcome of gastroschisis: a 20-year case review of infants with gastroschisis born in Galveston, Texas",
abstract = "Background/Purpose: In the past decade, the preferred method of closure of gastroschisis at our institution has been staged reduction using a silo with repair on an elective basis (SR) rather than primary surgical closure (PC). We performed a 20-year case review of infants with gastroschisis at a university hospital to compare these shifts in management and to determine factors affecting outcome. Methods: Seventy-two cases were reviewed from 1983 to 2003. Times to first and full feeds were outcome variables for statistical analysis. Results: The prevalence of gastroschisis increased from 0.03{\%} to 0.1{\%} since 1983. Patients had low birth weights (mean = 2294 g) and were borderline premature (mean = 35.8 weeks). Only 3{\%} of the infants were African American. There was a high rate of cesarean deliveries (57{\%}). Ten patients (15{\%}) had gastroschisis complicated by liver herniation, intestinal atresia(s), and/or necrosis/perforation. Most patients were managed by SR (67{\%}). Eight percent of the infants died, 9{\%} developed necrotizing enterocolitis, and 50{\%} had other gastrointestinal complications. Twenty-seven percent of the infants managed with SR did not need initial mechanical ventilation. However, the patients who underwent SR were ventilated longer after birth as compared with those who underwent PC (P < .08). Infants with a complicated gastroschisis had significantly longer times to first and full feeds (P < .001). Patients managed with SR took significantly longer to reach full feeds (P = .001), and there was a trend of starting feeds later (P = .06). When patients with a complicated gastroschisis were excluded, the differences between the SR and PC groups were even greater (P = .01; P < .001). Conclusions: In our patient population, the prevalence of gastroschisis increased by more than 400{\%} since 1983. The defect was rare in African-American infants. Management by SR was associated with longer ventilation times and longer times to first and full feeds for both uncomplicated and complicated gastroschisis cases.",
keywords = "Gastroschisis, Gastroschisis repair, Outcome analysis",
author = "Eggink, {B. Hannie} and Carol Richardson and Michael Malloy and Angel, {Carlos A.}",
year = "2006",
month = "6",
doi = "10.1016/j.jpedsurg.2006.02.008",
language = "English",
volume = "41",
pages = "1103--1108",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Outcome of gastroschisis

T2 - a 20-year case review of infants with gastroschisis born in Galveston, Texas

AU - Eggink, B. Hannie

AU - Richardson, Carol

AU - Malloy, Michael

AU - Angel, Carlos A.

PY - 2006/6

Y1 - 2006/6

N2 - Background/Purpose: In the past decade, the preferred method of closure of gastroschisis at our institution has been staged reduction using a silo with repair on an elective basis (SR) rather than primary surgical closure (PC). We performed a 20-year case review of infants with gastroschisis at a university hospital to compare these shifts in management and to determine factors affecting outcome. Methods: Seventy-two cases were reviewed from 1983 to 2003. Times to first and full feeds were outcome variables for statistical analysis. Results: The prevalence of gastroschisis increased from 0.03% to 0.1% since 1983. Patients had low birth weights (mean = 2294 g) and were borderline premature (mean = 35.8 weeks). Only 3% of the infants were African American. There was a high rate of cesarean deliveries (57%). Ten patients (15%) had gastroschisis complicated by liver herniation, intestinal atresia(s), and/or necrosis/perforation. Most patients were managed by SR (67%). Eight percent of the infants died, 9% developed necrotizing enterocolitis, and 50% had other gastrointestinal complications. Twenty-seven percent of the infants managed with SR did not need initial mechanical ventilation. However, the patients who underwent SR were ventilated longer after birth as compared with those who underwent PC (P < .08). Infants with a complicated gastroschisis had significantly longer times to first and full feeds (P < .001). Patients managed with SR took significantly longer to reach full feeds (P = .001), and there was a trend of starting feeds later (P = .06). When patients with a complicated gastroschisis were excluded, the differences between the SR and PC groups were even greater (P = .01; P < .001). Conclusions: In our patient population, the prevalence of gastroschisis increased by more than 400% since 1983. The defect was rare in African-American infants. Management by SR was associated with longer ventilation times and longer times to first and full feeds for both uncomplicated and complicated gastroschisis cases.

AB - Background/Purpose: In the past decade, the preferred method of closure of gastroschisis at our institution has been staged reduction using a silo with repair on an elective basis (SR) rather than primary surgical closure (PC). We performed a 20-year case review of infants with gastroschisis at a university hospital to compare these shifts in management and to determine factors affecting outcome. Methods: Seventy-two cases were reviewed from 1983 to 2003. Times to first and full feeds were outcome variables for statistical analysis. Results: The prevalence of gastroschisis increased from 0.03% to 0.1% since 1983. Patients had low birth weights (mean = 2294 g) and were borderline premature (mean = 35.8 weeks). Only 3% of the infants were African American. There was a high rate of cesarean deliveries (57%). Ten patients (15%) had gastroschisis complicated by liver herniation, intestinal atresia(s), and/or necrosis/perforation. Most patients were managed by SR (67%). Eight percent of the infants died, 9% developed necrotizing enterocolitis, and 50% had other gastrointestinal complications. Twenty-seven percent of the infants managed with SR did not need initial mechanical ventilation. However, the patients who underwent SR were ventilated longer after birth as compared with those who underwent PC (P < .08). Infants with a complicated gastroschisis had significantly longer times to first and full feeds (P < .001). Patients managed with SR took significantly longer to reach full feeds (P = .001), and there was a trend of starting feeds later (P = .06). When patients with a complicated gastroschisis were excluded, the differences between the SR and PC groups were even greater (P = .01; P < .001). Conclusions: In our patient population, the prevalence of gastroschisis increased by more than 400% since 1983. The defect was rare in African-American infants. Management by SR was associated with longer ventilation times and longer times to first and full feeds for both uncomplicated and complicated gastroschisis cases.

KW - Gastroschisis

KW - Gastroschisis repair

KW - Outcome analysis

UR - http://www.scopus.com/inward/record.url?scp=33744909086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33744909086&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2006.02.008

DO - 10.1016/j.jpedsurg.2006.02.008

M3 - Article

C2 - 16769342

AN - SCOPUS:33744909086

VL - 41

SP - 1103

EP - 1108

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 6

ER -