Early Closure of Gastroschisis After Silo Placement Correlates with Earlier Enteral Feeding.
OBJECTIVE
Gastroschisis is a congenital anomaly affecting 2.3-4.4/10,000 births. Previous studies show initiation of early enteral feeds predicts improved outcomes. We hypothesize that earlier definitive closure after silo placement; can lead to earlier enteral feed initiation. Design/ Setting/ Duration: Retrospective review of patients with gastroschisis from 2005 and 2014 at a single institution.


METHODS
The data, including ethnicity, gestational age, birth weight, time to definitive closure, and time of first and full feeds, were analyzed using both Spearman's rho and the Kruskal-Wallis rank sum test where appropriate; a p value less than 0.05 was considered significant.


RESULTS
Forty-three patients (24 males, 19 females) born with gastroschisis were identified. Overall survival rate was 88% (38/43). Forty of the 43 patients had a silo placed prior to definitive closure. Median days to closure were 6 (0 to 85) days. First feeds on average began on day of life (DOL) 17, and full feeds on DOL 25. Earlier closure of gastroschisis correlated with early initiation of feeds (p=0.0001) and shorter time to full feeds (p=0.018), closure by DOL4 showed a trend toward earlier feeding (p=0.13).


CONCLUSIONS
Earlier closure of gastroschisis after silo placement was associated with earlier feed initiation and shorter time to full feeds.
Division of General Surgery, Rush University Medical Center. 1653 W. Congress Parkway Jelke Suite 792, Chicago.
Jamie
J
Harris
Division of General Surgery, Rush University Medical Center. 1653 W. Congress Parkway Jelke Suite 792, Chicago.
Jennifer
J
Poirier
Rush Fetal and Neonatal Medicine Center, Rush Children's Hospital. 1653 W Congress Pkwy 622 Murdock, Chicago.
Debra
D
Selip
Division of Pediatric Surgery, Rush University Medical Center. 1653 W. Congress Parkway Jelke Suite 792, Chicago.
Srikumar
S
Pillai
Division of Pediatric Surgery, Rush University Medical Center. 1653 W. Congress Parkway Jelke Suite 792, Chicago.
Ami
A
N Shah
Division of Pediatric Surgery, Floating Hospital for Children - Tufts Medical Center, 800 Washington Street, Boston.
Carl-Christian
CC
Jackson
Division of Pediatric Surgery, Rush University Medical Center. 1653 W. Congress Parkway Jelke Suite 792, Chicago.
Bill
B
Chiu
Closure timing; Enteral feeding; Gastroschisis; Silo