Gastroschisis: a 15-year experience.
Between January 1, 1971 and December 31, 1985, 59 cases of gastroschisis were treated at Hôpital Sainte-Justine in Montreal. In the period before 1978, 6 of 19 patients (31.6%) were closed primarily at the time of surgery and 13 of 19 patients (68.4%) had silon pouch closure. After 1978, 33 of 40 patients (82.5%) had primary closure and 7 of 40 (17.5%) had a silon pouch. Our overall mortality rate was 13.6%. The complication rate for the primary closure group was 25.6% with a 12.8% (5/39) mortality rate, interestingly, in the higher birth weight group. Those closed with a silon pouch had a 75% complication rate, mostly infectious, with 15% mortality. Neither low birth weight nor gestational age influenced mortality. A significant difference in the length of hospital stay was observed. This was 33.6 days for the primary closures and 56 days for the silon pouch closures. Our series demonstrates a definite favorable trend in the results of treatment of this malformation. The most important factor affecting these results is a change in surgical approach. Primary abdominal wall closure, being usually possible, should always be attempted. We also note an association between high birth weight and death due to bowel dysmotility.
D000009:Abdominal Muscles / Q000002:abnormalities* / Q000601:surgery; D004200:Diseases in Twins; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D008423:Maternal Age; D009026:Mortality; D011183:Postoperative Complications / Q000453:epidemiology