Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes

Early Primary Repair of Gastroschisis Without General Anaesthesia

“…7 Prenatal diagnosis and transfer of patient to a specialized center is in favor of more frequent successful primary closure, less postoperative ventilation and reduced hospital stay because of earlier surgery and early management of patient. 8 Reduction of the abdominal content should be done within hours after birth, as delay in repair may cause water and heat loss from the exposed bowel, compromised gut circulation and infarction.…”

“…7 If primary closure is not possible because of insufficient size of abdominal domain, an artificial pouch or silo is constructed to contain the eviscerated abdominal content. Premade SILASTIC (Dow Corning, Midland, MI) silo with spring loaded rings (SLS) as well as various technique for silo construction are used.…”

Recent Advances in Neonatal Gastroenterology and Neonatal Nutrition

“…Primary reduction under general anaesthesia is the traditional and commonly used approach is to reduce the viscera followed by the closure of the fascia and the skin with sutures under general anaesthesia (Owen et al 2010). It will also enable the repair of associated anomalies such as intestinal atresia.…”

“…The idea behind this approach is the potential for avoidance of general anaesthesia, avoidance of transfer to a surgical unit and facilitation of early enteral feeds because complete reduction has been achieved very early. This approach was pioneered in the United Kingdom, (Bianchi et al 2002) but not adopted with enthusiasm (Owen et al 2010). In Western Australia, this procedure has been abandoned in view of high incidence of complications ).…”

“…Survival rate of neonates with gastroschisis is high (93-97%) (Abdel-Latif et al 2008, Baird et al 2011, Owen et al 2010. The median time to discharge home range between 23 to 47 days , Baird et al 2011, infants with short gut syndrome have very prolonged hospitalisation with the risk of complications of prolonged TPN therapy such as cholestasis and recurrent infections.…”