BACKGROUND: Gastroschisis is a common developmental anomaly of the abdominal front wall. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique. The objective of this paper is to analyze our 20-year experience with surgical treatment of gastroschisis with primary and staged closure, to compare the postoperative course for the said techniques as well as to identify factors influencing the course and early results of treatment. METHODS: The research materials consist of a retrospective analysis of medical history of patients treated at the Pediatric Surgery Clinic in Poznan over 20 years period from 2000 to 2019. 59 patients were operated on: 30 girls and 29 boys. RESULTS: Surgical treatment was performed in all the cases. Primary closure was performed in 32% of the cases, whereas staged silo closure was performed in 68% of the cases. Postoperative analgosedation was used for 6 days on average after primary closures, and 13 days on average after staged closures. Generalized bacterial infection was present in 21% of patients treated with primary closures and 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later (day 22) than those treated with primary closure (day 12). CONCLUSIONS: It is not possible to indicate clearly which surgical technique is superior to the other based on the results obtained. When choosing the treatment method, the patient's clinical condition, associated anomalies, and the medical team's experience must be taken into consideration.

The frequency rate of esophageal anastomosis leaks after thoracoscopic correction of esophageal atresia (EA) in the current literature is reported as 5.6%–24.7% and a conversion rate of 2%–53%. The objective of this retrospective study was to examine the characteristics of EA and analysis of the safety and efficacy of EA repair with the use of the thoracoscopic approach in a single academic center, as well as risk factors analysis in the context of short-term and mid-term follow-up status. A retrospective analysis of the management of all consecutive newborns affected by EA hospitalized in our department over a period between 2013 and 2022, including preoperative, perioperative, and postoperative management, together with the outcome, complications and long-term follow-up status was performed. A total of 38 patients with a median birth weight of 2,570 g (range; 1,020–3,880) were treated over the study period, including 30/38 (78.9%) with additional congenital anomalies. Overall, 30 patients underwent primary anastomosis of the esophagus and eight underwent a multistaged procedure, with or without an initial ligation of the tracheoesophageal fistula and delayed primary anastomosis. Overall survival for all patients was 0.894 ± 0.050, with a median follow-up of 4.5 years. We noted neither anastomotic leaks nor conversions to open technique in our cohort. Implementation of vancomycin prophylaxis was successful in preventing postoperative central venous access-related infectious complications. At the end of the follow-up, 85% of patients have a Lansky performance score ≥80. Risk factors analysis for length of hospitalization, overall survival, Lansky performance status, and neurological impairment were analyzed. In conclusion, we have found that the outcome of thoracoscopic repair of EA in terms of surgery-dependent morbidity (anastomosis leakage, conversion rate to open surgery), provides benefit to those previously reported in the literature, regardless of the prognostic criteria of the classification system.

BACKGROUND: Gastroschisis belongs to common developmental anomalies. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique.The objective of this paper is to analyze our 20-year experience with surgical treatment of gastroschisis with primary and staged closure, to compare the postoperative course for the said techniques as well as to identify factors influencing the course and early results of treatment.METHODS: The research materials comprise of a retrospective analysis of medical history of patients treated at the Surgery Clinic in Poznan in the years 2000-2019. 59 patients were operated on: 30 girls and 29 boys.Surgical treatment was performed with the use of primary closure in 33% of the cases, whereas the staged silo closure was performed in 67% of the cases. RESULTS: Postoperative analgosedation was used for 6 days on average after primary closures, and for 13 days on average after staged closures. Incidence frequency of generalized bacterial infection was 21% for primary closures and 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later (day 22) than those treated with primary closure (day 12). CONCLUSIONS: It is not possible to indicate clearly which surgical technique is superior to the other on the basis of the results obtained. When choosing the treatment method, the patient's clinical condition, associated anomalies and the medical team's experience must be taken into consideration.