New method of surgical delayed closure of giant omphaloceles: Lazaro da Silva's technique.
OBJECTIVE
The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients.


METHODS
Ventral hernias of 11 conservatively treated patients were corrected by Lazaro da Silva's technique from 1987 to 2002 in Clinic's Hospital of UFMG. The surgical procedure consisted of the bilateral longitudinal fibroperitoneal-aponeurotic transposition, resulting in 3 different layers of closure. The evolution of these patients is reported.


RESULTS
The presence of associated anomalies was observed in 8 patients (73%), with a predominance of cardiac defects. No alterations were associated with the use of silver sulfadiazine for epithelialization. Despite the size of the ventral hernia, no difficulties were related to the surgical procedure. Furthermore, no peri- and postoperative complications were observed. The hospital stay was approximately 8 days. The aesthetic result was excellent in all patients, and no recurrence of ventral hernia was observed.


CONCLUSIONS
These results lead to the conclusion that conservative management of giant omphaloceles with delayed closure of the ventral hernia using Lazaro da Silva's technique is a safe and reliable approach for treating these critically ill patients.
Pereira
Regina M
RM
Pediatric Surgery Unit of Clinics Hospital of the Federal University of Minas Gerais (UFMG), Minas Gerais, Brazil.
Tatsuo
Edson S
ES
Simões e Silva
Ana C
AC
Guimarães
José Teixeira
JT
Paixão
Ricardo Mattos
RM
Lanna
José C B
JC
Miranda
Marcelo E
ME
D000015:Abnormalities, Multiple / Q000601:surgery*; D001506:Beckwith-Wiedemann Syndrome / Q000601:surgery; D002675:Child, Preschool; D003456:Cryptorchidism / Q000601:surgery; D006330:Heart Defects, Congenital / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery; D006554:Hernia, Umbilical / Q000601:surgery*; D006801:Humans; D007902:Length of Stay; D008297:Male; D013524:Surgical Flaps; D013536:Suture Techniques; D016896:Treatment Outcome