[Gastroschisis. Management. 50 cases].
OBJECTIVE
Demonstrate the need for a multidisciplinary antenatal approach to laparoschisis.


METHODS
A retrospective series of 50 children who underwent surgery for laparoschisis between 1975 and 1994 in the Infant Surgery Department of the Strasbourg University Hospitals. Postoperative outcomes were evaluated as a function of the stage of laparoschisis and surgical technique. Follow-up was also examined.


RESULTS
Depending on the periods evaluated, ultrasound diagnosis varied from 16 to 92% and was made at 21 weeks gestation on the average. Lesions observed were atresia of the bowel (10%), complete intestinal involution (2%), and perivisceritis (88%). Complete parietal closure was achieved after bowel emptying in 58% of the newborns. Postoperative mortality, usually in vere severe forms, fell from 46% to 15% over the 20-years study period.


CONCLUSIONS
Antenatal echography can confirm the diagnosis of laparoschisis. It can be used to define risk factors (size, bowel dilatation(s), mesenteric blood flow) allowing planned extraction in an Infantile Surgery Unit. This multidisciplinary attitude should help to improve overall outcome.
D000009:Abdominal Muscles / Q000002:abnormalities*; D000293:Adolescent; D000328:Adult; D000013:Congenital Abnormalities / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010348:Patient Care Team; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
Laparoschisis. Prise en charge. A propos de 50 cas.