G140(P) Gastroschisis: a 9 year single centre experience

Abstract

Aims To describe the outcomes of all babies with gastroschisis managed over a 9 year period at a single surgical unit. Methods Retrospective study of all infants with gastroschisis, repaired between Jan 2007 to Jan 2016. They were analysed according to Simple vs Complex Gastroschisis and the Simple group subdivided into Primary vs Staged Closure. Results We identified 56 babies. There were 45 simple and 10 complex cases. One baby was excluded with a closed gastroschisis. 26 babies with Simple Gastroschisis had primary and 19 had staged closure. No deaths were noted. No significant differences in operative complications and unplanned re-operations were demonstrated. The median length of stay, time to full feeds and parenteral nutrition duration was not significantly different between simple and complex gastroschisis groups. There was a significant difference in days to first feed and parenteral nutrition duration in Simple Gastroschisis managed with Primary closure and Staged closure (table 1). Conclusions Simple vs Complex Gastroschisis: a. There was a higher but non significant risk of operative complications in the complex group. b. No statistically significant difference between the simple and complex groups. A sizable proportion of complex patients were excluded as they did not achieve outcome or were transferred to other units. Primary vs Staged closure in Simple Gastroschisis: a. No statistically significant difference in operative complications between primary and staged groups. b. Patients who underwent primary closure had significantly shorter times to first feed and a shorter durationof parenteral nutrition. This study describes our practice and contributes to the growing pool of data regarding gastroschisis. In the absence of consensus, this may aid management decisions and reduce adverse outcomes.