The survivors of gastroschisis

Abstract

Aims-To assess the long term morbidity and quality of life in survivors of gastroschisis. Design-All babies born with gastroschisis between 1972 and 1984 and who survived more than one year were identified. Those who could be traced were questioned about their general health, growth, abdominal symptoms, cosmetic concerns, education, employment, and fertility. Results-Of the 35 patients, two have died, seven could not be traced, and three declined to be interviewed. Twenty three subjects (70% of survivors) with a median age of 16 years (range 12-23 years) responded. Twenty two (96%) were in good health and overall growth was within normal limits. Eight subjects (35%) have had further surgery related to gastroschisis, including two for adhesive small bowel obstruction and three for scar complications. In 13 (57%), absence of an umbilicus caused distress during childhood. Conclusion-Most gastroschisis survivors can eventually expect normal growth and good health. Adhesive bowel obstruction is an uncommon, but potentially late, complication. The umbilicus should be conserved during gastroschisis repair. (Arch Dis Child 1997;77:158-160)

Hospital readmission among infants with gastroschisis

“…10,11 These conclusions are based on individual physician experience, small numbers of patients and studies with methodological limitations. The present study does not support that consensus.…”

Growth and neurodevelopment at 16 to 24 months of age for infants born with gastroschisis

“…[8][9][10][11]13 In studies published more than 20 years ago, 30 to 40% of survivors were less than the 10th percentile for weight at follow-up. 8,13,20 Berseth et al 8 described a case series of infants with either gastroschisis or omphalocele, who were born between 1964 and 1977, and observed minimal catch-up growth for both weight and length.…”

“…6 The impact of gastroschisis on growth and neurodevelopment, based on previous studies, is uncertain because of limitations in study design, including small cohort sizes, the inclusion of patients with unrelated abdominal wall defects, evaluations by report only and the inclusion of patients born greater than 20 years ago. [8][9][10][11] As a result, some studies report normal growth, and others report a high percentage of growth failure. [11][12][13] Neurodevelopmental findings also vary, with both impaired development 8 and normal development 12 reported.…”

Gastroschisis: ward reduction compared with traditional reduction under general anesthesia

“…Outcomes for the traditional approach to gastroschisis have been summarized in several case series [5], [6], [7], [9] and [10]. Hospital mortality ranges from 7% to 10%, often related to septicemia.…”

“…There is normally a prolonged hospital admission with a median duration of around 6 weeks in most series. Other possible complications of gastroschisis include hemodynamic compromise of the lower abdomen, kidneys and legs with abdominal compartment syndrome; gut perforation; infection (septicemia and/or wound infection); abdominal scars; a cosmetically abnormal umbilicus; late surgery for gut adhesions or scar cosmesis; compromised nutrition; and adverse neurologic outcome [9], [10] and [11]. Bianchi and Dickson [1] reported 14 cases treated with reduction in the neonatal unit-there were 12 survivors: 9 uncomplicated, 2 with mild periumbilical inflammation, and 1 requiring an intestinal lengthening procedure for ileal atresia.…”