Gastroschisis revisited: role of intraoperative measurement of abdominal pressure

Olesevich, Max; Alexander, Frederick; Khan, Mohammad Shahnewaz; Cotman, Kathy

doi:10.1016/j.jpedsurg.2005.01.043

Cited by 51 publications

(29 citation statements)

References 14 publications

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“…Our successful PR rate of 74% is consistent with previously published rates, which have ranged from 79% to 93% [2,5,6,9,12,13]. Although there have been disparate results regarding outcomes of PR versus preformed silo [5,9,14], most of the prior studies have not separated patients by intention to treat, and none of the other studies have looked at time to closure as a continuous variable.…”

Section: Discussionsupporting

confidence: 86%

Method to our madness: an 18-year retrospective analysis on gastroschisis closure

Banyard

Ramones

Phillips

et al. 2010

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 86%

Method to our madness: an 18-year retrospective analysis on gastroschisis closure

Banyard

Ramones

Phillips

et al. 2010

Journal of Pediatric Surgery

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“…The treatment of choice for gastroschisis has been extensively debated and literature presents a great heterogeneity among the available evidence [17][18][19][20][21]. Closure-related complications after primary closure could be minimized with the use of more objective measurements for excessive intra-abdominal pressure peri-operatively [22,23]. According to Olesevich et al [23], measuring the intra operative bladder pressure as parameter for intra-abdominal pressure improves the safety of primary closure by avoiding bowel ischemia and leads to a shorter time to feeds and reduced length of hospital stay.…”

Section: Discussionmentioning

confidence: 99%

Factors determining outcome in gastroschisis: clinical experience over 18 years

Jager

Heij

2007

Pediatr Surg Int

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Although the survival in gastroschisis has improved to more than 85%, serious morbidity with consequent long hospital stay is still very common. Alternative strategies such as planned early delivery and amniotic fluid exchange are being explored. In order to evaluate these approaches, adequate risk stratification of patients with gastroschisis is required. The aim of this study was to identify the risk factors associated with increased morbidity and mortality. A retrospective analysis of all patients with gastroschisis treated at our institution between 1988 and 2005 was conducted. Patients' data were collected from the files and compared for statistical significance with three outcome measures: (1) complicated post-operative course; (2) time to full enteral feeding (TFE); (3) length of hospital stay (LOS). SPSS was used for statistical analysis. Fifty-nine newborns with gastroschisis were admitted during the study period. Antenatal diagnosis was made in 40 cases (68%). Associated malformations (other than intestinal anomalies) were present in eight patients. One patient with trisomy 13 was excluded from the analysis. Ten patients (17%) had compromised bowel (atresia, severe ischaemia or a combination). Primary repair was successful in 47 (81%) and in 11 patients a silo was applied. Overall survival was 54/58 children (93%), four patients died. Complications associated with closure occurred in eight patients. Postoperative course was uncomplicated in 45 patients and complicated in 13. The RR for patients with compromised bowel to have a complicated post-operative course is 9 (95% CI 2-39) and the RR to die is 20 (95% CI 2-222) for these patients. Risk stratification of patients with gastroschisis appears possible based on the presence of compromised bowel before closure.

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“…Again, all patients with bladder pressure of less than 20 mm Hg were closed primarily (79% of patients). There were no complications that were attributed to bowel ischemia and no reoperations in this group [21].…”

Section: Discussionmentioning

confidence: 66%

Splanchnic perfusion pressure: a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis

McGuigan

Mullenix

Vegunta

et al. 2006

Journal of Pediatric Surgery

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Gastroschisis revisited: role of intraoperative measurement of abdominal pressure

Cited by 51 publications

References 14 publications

Method to our madness: an 18-year retrospective analysis on gastroschisis closure

Method to our madness: an 18-year retrospective analysis on gastroschisis closure

Factors determining outcome in gastroschisis: clinical experience over 18 years

Splanchnic perfusion pressure: a better predictor of safe primary closure than intraabdominal pressure in neonatal gastroschisis

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