Objective: In infants with gastroschisis, outcomes were compared between those where operative reduction and fascial closure were attempted ≤24 hours of age (PC), and those who underwent planned closure of their defect >24 hours of age following reduction with a pre-formed silo (SR).
Summary Of Background Data: Inadequate evidence exists to determine how best to treat infants with gastroschisis.
Methods: A secondary analysis was conducted of data collected 2006-2008 using the British Association of Pediatric Surgeons Congenital Anomalies Surveillance System, and 2005-2016 using the Canadian Pediatric Surgery Network.28-day outcomes were compared between infants undergoing PC and SR. Primary outcome was number of gastrointestinal complications. Interactions were investigated between infant characteristics and treatment to determine whether intervention effect varied in sub-groups of infants.
Results: Data from 341 British and Irish infants (27%) and 927 Canadian infants (73%) were used. 671 infants (42%) underwent PC and 597 (37%) underwent SR. The effect of SR on outcome varied according to the presence/absence of intestinal perforation, intestinal matting and intestinal necrosis. In infants without these features, SR was associated with fewer gastrointestinal complications [aIRR 0.25 (95% CI 0.09-0.67, P = 0.006)], more operations [aIRR 1.40 (95% CI 1.22-1.60, P < 0.001)], more days PN [aIRR 1.08 (95% CI 1.03-1.13, P < 0.001)], and a higher infection risk [aOR 2.06 (95% CI 1.10-3.87, P = 0.025)]. In infants with these features, SR was associated with a greater number of operations [aIRR 1.30 (95% CI 1.17-1.45, P < 0.001)], and more days PN [aIRR 1.06 (95% CI 1.02-1.10, P = 0.003)].
Conclusions: In infants without intestinal perforation, matting, or necrosis, the benefits of SR outweigh its drawbacks. In infants with these features, the opposite is true. Treatment choice should be based upon these features.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/SLA.0000000000004217 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Generation Victoria (GenV): protocol for a longitudinal birth cohort of Victorian children and their parents.
BMC Public Health
January 2025
Murdoch Children's Research Institute, 50 Flemington Road, Parkville, VIC, 3052, Australia.
Background: In a world confronted with new and connected challenges, novel strategies are needed to help children and adults achieve their full potential, to predict, prevent and treat disease, and to achieve equity in services and outcomes. Australia's Generation Victoria (GenV) cohorts are designed for multi-pronged discovery (what could improve outcomes?) and intervention research (what actually works, how much and for whom?). Here, we describe the key features of its protocol.
View Article and Find Full Text PDFThe clinical characteristics and surgical strategy in infants with lingual thyroglossal duct cyst.
Braz J Otorhinolaryngol
January 2025
Children's Hospital of Fudan University, Department of Otolaryngology-Head and Neck Surgery, Shanghai, China. Electronic address:
Objectives: Lingual Thyroglossal Duct Cysts (LTDCs) are a rare variant of thyroglossal duct Cyst (LDC). This study aimed to explore the efficacy of transoral excision of LTDC and evaluate the added benefit of concomitant management of laryngomalacia during the surgical intervention.
Methods: Infants with LTDCs were retrospectively collected from our department from January 2009 to January 2022.
[DiGeorge syndrome with 22q11.2 deletion in a patient of Rarámuri ethnicity].
Rev Alerg Mex
December 2024
Departamento de Inmunología, Hospital Infantil de Especialidades de Chihuahua; Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua.
Background: 22q11 deletion syndrome consists of a variable grouping of phenotypic features and immunological defects secondary to the loss of genetic material located in the 22q11.2 band. The 22q11 deletion spectrum encompasses different syndromes related to the same etiology and with overlapping anomalies, including DiGeorge syndrome, velocardiofacial syndrome, among others.
View Article and Find Full Text PDFCausal Relationships Between Leukocyte Subsets and Adverse Fetal Outcomes: A Mendelian Randomization Study.
Mediators Inflamm
January 2025
Department of Bioinformatics, School of Basic Medical Sciences, Chongqing Medical University, Chongqing 400016, China.
The tolerance and dynamic regulation of the maternal immune system during pregnancy are pivotal for ensuring fetal health. Immune cell subsets play a complex and crucial role in this process, closely linked to the neonatal health status. Despite recognizing the significance of dysregulation in the quantity and activity of immune cells in neonatal disease occurrence, their specific roles remain elusive, resulting in a dearth of clinically viable interventions for immune-mediated neonatal diseases.
View Article and Find Full Text PDFForeign body ingestion in children: Clinical features and complications.
Tunis Med
December 2024
Department of Pediatric Medicine B, Béchir Hamza Children's Hospital, Faculty of Medicine of Tunis, Tunis el Manar University, Tunis, Tunisia.
Introduction: The ingestion of foreign body (FB) is a common problem in paediatrics. Children are curious by nature and tend to explore environment by inserting objects into their mouths.
Aim: To update our epidemiological and clinical data and adapt clinical management in order to limit morbidity associated with this fairly frequent accidental pathology.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!