title: Canadian Pediatric Surgical Network: a population-based pediatric surgery network and database for analyzing surgical birth defects. The first 100 cases of gastroschisis.
abstract: OBJECTIVE
  Outcomes studies for gastroschisis are constrained by small numbers, prolonged accrual, and nonstandardized data collection. The aim of this study is to create a national pediatric surgical network and database for gastroschisis (GS) that tracks cases from diagnosis to hospital discharge.
  
  
  METHODS
  The 16-center network serves a population of 32 million. Gastroschisis cases are ascertained at prenatal diagnosis. Perinatal data include maternal risk and fetal ultrasound variables, delivery plan and outcome, a postnatal bowel injury score, intended and actual surgical treatment, and neonatal outcomes. Institutional review board-approved data collection conforms to regional privacy legislation. Deidentified data are centralized and accessible for research through the network steering committee.
  
  
  RESULTS
  To date, 114 cases of pre- and/or postnatal gastroschisis have been uploaded. Of 106 live-born infants (40 [38%] by cesarean delivery), 100 had complete records, and overall survival to discharge was 96%, with a mean survivor length of stay (LOS) of 46 days. Infants treated with attempted urgent closure (61%) had significantly shorter LOS (42 vs 57 days; P = .048) but comparable LOS compared with those treated with silos and delayed closure. Fetal bowel dilation 18 mm or greater did not predict a difference in outcome.
  
  
  CONCLUSIONS
  Population-based databases allow rapid case accrual and enable studies that should aid in the identification of optimal perinatal treatment.
authors.affiliation: Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada. eskarsgard@cw.bc.ca
authors.forename: Erik D
authors.initials: ED
authors.lastname: Skarsgard
authors.forename: Jennifer
authors.initials: J
authors.lastname: Claydon
authors.forename: Sarah
authors.initials: S
authors.lastname: Bouchard
authors.forename: Peter C W
authors.initials: PC
authors.lastname: Kim
authors.forename: Shoo K
authors.initials: SK
authors.lastname: Lee
authors.forename: Jean-Martin
authors.initials: JM
authors.lastname: Laberge
authors.forename: Douglas
authors.initials: D
authors.lastname: McMillan
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
authors.forename: Natalie
authors.initials: N
authors.lastname: Yanchar
mesh_terms: D034861:Abdominal Wall / Q000601:surgery; D002170:Canada / Q000453:epidemiology; D003219:Confidentiality; D000013:Congenital Abnormalities / Q000453:epidemiology / Q000601:surgery; D003628:Database Management Systems; D005260:Female; D020139:Gastroschisis / Q000453:epidemiology* / Q000601:surgery*; D013502:General Surgery / Q000458:organization & administration*; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007255:Information Services; D008297:Male; D010372:Pediatrics / Q000458:organization & administration*; D011247:Pregnancy; D011296:Prenatal Diagnosis; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate; D016896:Treatment Outcome