Short-Term and Long-Term Problems After Duraplastic Enlargement of Anterior Abdominal Wall

Klein, Pamela E.; Hp, Hümmer; Wellert, S; Faber, Thomas

doi:10.1055/s-2008-1042466

Cited by 13 publications

(8 citation statements)

References 5 publications

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“…In diesen Fäl-len wird die Bauchhöhle plastisch vergröûert und die Fascie zweizeitig verschlossen; geeignete Methoden sind Verschluû der Haut ohne Reposition des Eventrats mit Modifikationen, Einnaht eines Silasticsacks an die Rectusränder oder an die Haut mit oder ohne Resektion des OC-Sacks sowie Faltung eines silasticbeschichteten Polyesternetzes und eventuell spätere SilasticPatch-Deckung, Verwendung des OC-Sacks als Silo-Ersatz oder Einsatz von lyophilisierter Dura, Amnion bzw. PTFE oder eines Gewebeexpanders [10,12,15,16,21,30]. Komplikationen sind Wundrandinfektion und -risse, Peritonitis, Sepsis, Darmfisteln, Volvulus und Nekrose.…”

Section: Behandlungsstrategien Und Ihre Komplikationen In Der Literaturunclassified

“…16 von 25 (GS) Defekten direkt primär verschlossen, danach 9 von 12; nach 1990 wurde zur Deckung sehr groûer Defekte 3mal Amnion und/ oder Dura eingesetzt. Dieses Verfahren bot auch bei anderen Autoren [11,15] eine erfolgreiche Alternative. Bei Defekten über 5±7 cm (meist mit Leberhernierung) besteht hinsichtlich des Verfahrens in der Literatur kein Konsens über die optimale Methode; in der Mehrzahl wird die Silo-Technik mit Modifikationen eingesetzt.…”

Section: Diskussionunclassified

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Omphalocele und Gastroschisis Ergebnisse – Komplikationen – Verlauf – Lebensqualität

Kaiser

Kahl

Schwabe

et al. 2000

Chirurg

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From 1970 to 1998, 35 children with omphalocele (OC) and 31 with gastroschisis (GS) were treated at the Department of Paediatric Surgery at Lübeck Medical University. Forty of 43 survivors were examined in 1990, the data of 30 patients were renewed in 1999 and 12 new cases added. Total follow-up was 1-28 years. Primary closure was possible in 25 OCs and 20 GSs. Eighteen children with OC and 8 with GS suffered from additional abnormalities, which were treated simultaneously. Twenty percent of the babies with OC died mostly because of severe congenital anomalies and 12.9% of GS because of infectious complications in combination with other diseases. There were no more deaths in the last decade. Accordingly, there was a reduction in consecutive operations. Improvements were due to better operative and perioperative treatment as well as abortions following improved ultrasound examinations. The results of the literature and our own experience show the benefit of primary closure. A two-stage approach with dura/amnion or a silo procedure prevents high intra-abdominal pressure, therefore, indirect measurements of intra-abdominal pressure can be used exceptionally. Umbilical preservation offers better cosmetic results. Long-term follow-up reveals normal growth and development of the children except for those with severe congenital anomalies. All the others are participating without problems in normal activities and education without reduction in their quality of life. Today an isolated OC or GS is not an indication for abortion. If prenatal OC or GS is diagnosed, paediatric surgeons should be involved in the consultations.

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Section: Behandlungsstrategien Und Ihre Komplikationen In Der Literaturunclassified

Section: Diskussionunclassified

Omphalocele und Gastroschisis Ergebnisse – Komplikationen – Verlauf – Lebensqualität

Kaiser

Kahl

Schwabe

et al. 2000

Chirurg

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“…Gastroschisis should be corrected as soon as possible after delivery [7]. Most reports describe primary closure of the abdominal wall as the treatment of choice [7,16], but care must be taken to avoid intra-abdominal pressures higher than 20 cm H 2 O [17]. Primary closure can be achieved in 67% of cases [4,8,11,16,18].…”

Section: Introductionmentioning

confidence: 99%

Gastroschisis and omphalocele: treatments and long-term outcomes

et al. 2007

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Between February 1994 and April 2004, we treated 40 children with gastroschisis and 26 children with omphalocele. We recorded the course of pregnancy, pre- and post-natal complications, delivery, operation, post-operative therapy, and long-term outcomes. Additionally, we conducted follow-up examinations of 37 of these 66 children (56%). We analysed their abdominal musculature, development, cosmetic result and quality of life. The median duration of follow-up was 6.3 years (range 1-10). In 35/40 children (88%) with gastroschisis and in 18/26 children (69%) with omphalocele, there had been prenatal diagnosis. The average maternal age of 23.9 years in the gastroschisis group was lower than in the omphalocele group (29.9 years). Delivery was by caesarean section in 93% of the gastroschisis group and 65% of the omphalocele group. Outcomes following vaginal delivery were no worse than those after caesarean section. Further, congenital abnormalities were shown in 28% of gastroschisis cases, and were limited to the gastrointestinal tract. Of the omphalocele cases 81% showed further abnormalities. Direct closure of the abdominal wall defect was possible in 31/40 (78%) of the gastroschisis cases and 15/26 (58%) of the omphalocele cases. Mortality in gastroschisis was nil; two children with omphalocele died (8%). Outcomes were better after primary closure than in stepwise reconstruction. Follow-up showed good results in all categories. Developmental delays were rapidly made up after treatment, and 75% of the children had no gastrointestinal problems, or suffered from these rarely. Almost all the children were of normal weight and height, and physical and intellectual development were delayed in only one third of the children. The surgical scar was rated as good or very good in about 80% of the cases. Except for those with severe defects, the children had good ratings for quality of life. Improvements in short-term results of gastroschisis and omphalocele treatment can be attributed to recent developments in prenatal diagnosis and the advancements of centralised perinatal care. Our long-term results clearly demonstrate that initial gastrointestinal problems and developmental delays were made up during the first two years of life. Prenatal counselling can now be more optimistic.

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“…Of these, the e-mail addresses of the authors of 10 articles could not be traced [7,9,12,13,26,29,[34][35][36]42]. Eight of the 10 articles were published before the era of e-mail announcement in the articles [7,9,12,29,[34][35][36]42]. The questionnaire was sent to the remaining 38 authors or coauthors.…”

Section: Resultsmentioning

confidence: 99%

“…The described surgical techniques were categorized according to the literature as primary closure (defined as primary closure of the defect in one operation, with or without extracorporal material, shortly after birth) [1][2][3][4][5][6][7][8][9][10], staged closure (closure of the abdominal wall defect in more than 1 operative procedure) , and delayed closure of the abdominal wall after epithelialization of the OC sac [36][37][38][39][40][41][42][43][44][45][46][47][48].…”

Section: Methodsmentioning

confidence: 99%

Past and current surgical treatment of giant omphalocele: outcome of a questionnaire sent to authors

Eijck

Aronson

Hoogeveen

et al. 2011

Journal of Pediatric Surgery

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Short-Term and Long-Term Problems After Duraplastic Enlargement of Anterior Abdominal Wall

Cited by 13 publications

References 5 publications

Omphalocele und Gastroschisis Ergebnisse – Komplikationen – Verlauf – Lebensqualität

Omphalocele und Gastroschisis Ergebnisse – Komplikationen – Verlauf – Lebensqualität

Gastroschisis and omphalocele: treatments and long-term outcomes

Past and current surgical treatment of giant omphalocele: outcome of a questionnaire sent to authors

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