Evolution of Staged Versus Primary Closure of Gastroschisis

Joseph N. Kidd, Richard J. Jackson, Samuel D. Smith, Charles W. Wagner, J. Alex Haller, Max Langham, H. Biemann Othersen, Judson G. Randolph

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Objective: Since the introduction of a preformed silo to the authors' practice in 1997, there has been a decrease in primary closure of gastroschisis. To clarity the impact of this change, the authors reviewed their results over the past 10 years. Methods: From patient records, the authors abstracted the closure method, mechanical ventilation days, time to full feeds, mechanical and infectious complications, and length of stay. The authors compared groups using the Student t test and the Mann-Whitney test, as appropriate. Results: Between 1993 and the present, 124 patients were identified. Between 1993 and 1997, 38 children presented with gastroschisis. Thirty-two (84.2%) closures were primary and six (18.8%) were staged. After 1997, the authors treated 80 children with gastroschisis. There were 27 (33.8%) primary and 53 (66.2%) staged closures. Six patients with other lethal anomalies were excluded. Length of stay and ventilator days were higher for the staged closure group, but infection and mechanical complications were less common in the staged closure group. The time to full feeds did not differ. Conclusions: A lower incidence of infection and complications related to abdominal compartment syndrome has made staged closure of gastroschisis more common in the authors' practice. While it has resulted in a longer hospital stay, staged closure decreases the risk of long-term bowel dysfunction and need for reoperation.

Original languageEnglish (US)
Pages (from-to)759-765
Number of pages7
JournalAnnals of Surgery
Volume237
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

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Gastroschisis
Length of Stay
Intra-Abdominal Hypertension
Mechanical Ventilators
Infection
Reoperation
Artificial Respiration
Students
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kidd, J. N., Jackson, R. J., Smith, S. D., Wagner, C. W., Haller, J. A., Langham, M., ... Randolph, J. G. (2003). Evolution of Staged Versus Primary Closure of Gastroschisis. Annals of Surgery, 237(6), 759-765. https://doi.org/10.1097/00000658-200306000-00003

Evolution of Staged Versus Primary Closure of Gastroschisis. / Kidd, Joseph N.; Jackson, Richard J.; Smith, Samuel D.; Wagner, Charles W.; Haller, J. Alex; Langham, Max; Othersen, H. Biemann; Randolph, Judson G.

In: Annals of Surgery, Vol. 237, No. 6, 01.06.2003, p. 759-765.

Research output: Contribution to journalArticle

Kidd, JN, Jackson, RJ, Smith, SD, Wagner, CW, Haller, JA, Langham, M, Othersen, HB & Randolph, JG 2003, 'Evolution of Staged Versus Primary Closure of Gastroschisis', Annals of Surgery, vol. 237, no. 6, pp. 759-765. https://doi.org/10.1097/00000658-200306000-00003
Kidd JN, Jackson RJ, Smith SD, Wagner CW, Haller JA, Langham M et al. Evolution of Staged Versus Primary Closure of Gastroschisis. Annals of Surgery. 2003 Jun 1;237(6):759-765. https://doi.org/10.1097/00000658-200306000-00003
Kidd, Joseph N. ; Jackson, Richard J. ; Smith, Samuel D. ; Wagner, Charles W. ; Haller, J. Alex ; Langham, Max ; Othersen, H. Biemann ; Randolph, Judson G. / Evolution of Staged Versus Primary Closure of Gastroschisis. In: Annals of Surgery. 2003 ; Vol. 237, No. 6. pp. 759-765.
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