title: Surgical Management of Congenital Abdominal Wall Defects in Germany: A Population-Based Study and Comparison with Literature Reports.
abstract: IntroductionWe aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports.Patients and MethodsData of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment.ResultsPatients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p= 0.003) and hospitalization (p< 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study.ConclusionUnbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.
authors.affiliation: Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Carmen
authors.initials: C
authors.lastname: Dingemann
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Janine
authors.initials: J
authors.lastname: Dietrich
authors.affiliation: Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Zeidler
authors.affiliation: Representative Office of Lower Saxony, Techniker Krankenkasse (Health Insurance), Hannover, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Blaser
authors.affiliation: Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.|Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: Jan Hendrik
authors.initials: JH
authors.lastname: Gosemann
authors.affiliation: Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.|Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Lacher
authors.affiliation: Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
authors.forename: Benno
authors.initials: B
authors.lastname: Ure
mesh_terms: D005260:Female; D005500:Follow-Up Studies; D020139:Gastroschisis / Q000601:surgery*; D005858:Germany; D006554:Hernia, Umbilical / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome