Abdominal wall defects in infants. Survival and implications for adult life.
OBJECTIVE
The authors study reviewed patients who underwent operations for omphalocele and gastroschisis to determine survival, morbidity, and long-term quality of life.


METHODS
Clinical follow-up of 94 patients cared for with omphalocele and gastroschisis during a 10- to 20-year period after birth.


RESULTS
Eighty-three patients survived initial treatment. Sixty-one had long-term follow-up. Mean follow-up in the group was 14.2 years. Survival was favorable in the absence of lethal or co-existing major congenital anomalies. Nineteen patients required 31 reoperations, most for abdominal wall hernias and the sequelae of intestinal atresia. Current quality of life was described as favorable (good) in 80% of patients.


CONCLUSIONS
Survival rate in patients with abdominal wall defects is favorable and deaths occur substantially in patients with co-existing lethal, or multiple, congenital anomalies. Reoperative surgery is necessary principally in those patients who have postclosure abdominal wall hernias, and in those with bowel atresia at birth. Reoperations are not likely to be necessary after school age. Quality of life in survivors is patient-perceived as entirely satisfactory.
Tunell
W P
WP
Department of Surgery, University of Oklahoma College of Medicine/Children's Hospital of Oklahoma, Oklahoma City, USA.
Puffinbarger
N K
NK
Tuggle
D W
DW
Taylor
D V
DV
Mantor
P C
PC
D000009:Abdominal Muscles / Q000002:abnormalities* / Q000601:surgery*; D005500:Follow-Up Studies; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D010289:Parenteral Nutrition, Total; D011182:Postoperative Care; D011788:Quality of Life; D012086:Reoperation; D012189:Retrospective Studies