Present Results in the Treatment of Omphalocele andGastroschisis

Overview

Objective:
The aim of the study was to evaluate current possibilities of treatment of newbornswith abdominal wall defects: omphalocele and gastroschisis.Setting: Department of Pediatric Surgery, 2nd Medical Faculty Charles University and FacultyHospital Motol, Prague.Methods: A retrospective cohort study of the treatment results in newborns with defect ofabdominal wall.Results: Thirty eight newborns with omphalocele and gastroschisis were treated at the authors`department in the period of 1995 - 2002. Primary closure of defect was possible in 23 newborns(60%), Goretex patch or „silo” technique was used in 13 patients (34%), while two newborns(6%) were not operated on. The overall survival in children with omphalocele was 73%, being89% in children without chromosomal anomalies. Six infants died: three with trisomy 13, onewith trisomy 18, one infant died of sepsis and one had primary pulmonary hypertension andcongenital heart defect. The survival in children with gastroschisis was 94%, one child died ofmultiorgan failure during sepsis.Conclusion: Nowadays prenatal diagnosis of gastroschisis or omphalocele is a recommendationfor complex examination and consultation in a specialized center. The prognosis for most isolateddefects of abdominal wall is good as far as survival and quality of life are concerned.

Key words:
abdominal wall defects, omphalocele, gastroschisis, prenatal diagnosis, survival,isolated defect