Gastroschisis: State of the Art in Translating Experimental Research to the Bedside

Abstract

The survival rate of newborns with gastroschisis (GS) has been increasing in the past decades; however, the morbidity continues to be high, mainly related to the length of hospitalization due to disturbances of motility, absorption, and risk of intestinal infections. The development of basic research with the creation of experimental models has provided enormous advances in the understanding of the pathophysiology of the disease. These models allowed the study of the target genes involved in the embryology of the defect, the influence of the amniotic fluid, and the use of drugs and fetal therapies in an attempt to reduce the intestinal damage and to provide a rapid return of intestinal motility. Our aim was to describe the main GS models and the translational, historical impact of these research advances on the disease.

Prenatal repair of gastroschisis using partial carbon dioxide insufflation fetoscopy: lessons learned

“…In an animal model, fetal death was frequently observed after correction and was mainly attributed to obstruction of blood flow at the level of the umbilical cord insertion site. (28) This may be the main challenge to overcome in future cases. In our case, we observed repeat herniation of the small bowel loops through a very small opening located just between the suture point and the insertion of the umbilical cord.…”

Experimental Models for Novel Therapies in Neonatal Surgery: Translational Approaches

“…Sbragia et al have reviewed the animal models of gastroschisis which have been in use for more than 35 years and have been instrumental for the understanding of the pathophysiology of the disease and for the testing of antenatal maneuvers. 4 These experimental studies have reproduced gastroschisis in different animals and with different approaches, including transgenic mice and surgically created models in the rat, rabbit, lamb, and chick. These studies have helped us elucidate phenomena that cause gastroschisis morbidities, such as intestinal inflammation and dysmotility, and to investigate the efficacy of interventions to prevent them, such as the amniotic fluid exchange.…”