A novel approach in the treatment of neonatal gastroschisis: a review of the literature and a single-center experience.
Gastroschisis is a congenital abdominal wall defect and its management remains an issue. We performed a review of the literature to summarize its evaluation, management and outcome and we describe a new type of surgical reduction performed in our center without anesthesia (GA), immediately after birth, in the delivery room. Between January 2002 and March 2013, we enrolled all live born infants with gastroschisis referred to the third-level Division of Obstetrics and Gynecology "San Camillo" of Rome. Two groups of infants were identified: group 1 in which gastroschis reduction was performed by the traditional technique and group 2 in which reduction was immediately performed after birth in the delivery room without GA. Twelve infants were enrolled in group 1, and seven infants in group 2. Statistical significance was observed between the groups regarding the hospital stay, for the duration of parenteral nutrition and full oral feeds (p = .004). Survival was similar between two groups. The reduction without GA performed immediately after birth in a delivery room encourages the relationship between the mother and her child and appears to be a safe and feasible technique in a selected group of patients with simple gastroschisis defect; for this reason, it could represent a valid alternative to traditional approach.
a Department of Pediatric Surgery and Urology , Azienda Ospedaliera San Camillo-Forlanini , Rome , Italy.
Vito
V
Briganti
b Department of Medicine, Unit of Gynaecology and Obstetrics , Università Campus Bio-Medico di Roma , Rome , Italy.
Daniela
D
Luvero
c Department of Urologic and Gynaecologic Sciences , Policlinico Umberto I, Sapienza - University of Rome , Italy.
Caterina
C
Gulia
d Institute of Molecular Biology and Pathology, National Research Council , Department of Biology and Biotechnologies , Sapienza - University of Rome , Italy.
Roberto
R
Piergentili
e Department of Anatomical, Histological Forensic and Orthopaedic Sciences , Sapienza - University of Rome , Italy.
Simona
S
Zaami
f Department of Neonatal Intensive Care , Azienda Ospedaliera San Camillo-Forlanini , Rome , Italy.
Elsa Laura
EL
Buffone
g Department of Gynaecology , Azienda Ospedaliera San Camillo-Forlanini , Rome , Italy.
Cristina
C
Vallone
b Department of Medicine, Unit of Gynaecology and Obstetrics , Università Campus Bio-Medico di Roma , Rome , Italy.
Roberto
R
Angioli
h Department of Obstetrics and Gynecology , Altamedica Main Center , Rome , Italy.
Claudio
C
Giorlandino
g Department of Gynaecology , Azienda Ospedaliera San Camillo-Forlanini , Rome , Italy.
Fabrizio
F
Signore
D003696:Delivery Rooms; D005260:Female; D020139:Gastroschisis / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D010288:Parenteral Nutrition; D011247:Pregnancy; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D016216:Ultrasonography, Prenatal
Gastroschisis defect; abdominal wall defects; neonatal surgery; surgical reduction