Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes
Gastroschisis: a national cohort study to describe contemporary surgical strategies and outcomes
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DOI：
10.1016/j.jpedsurg.2010.01.036
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发表时间：
2010-09-01
影响因子：
2.4
通讯作者：
Knight, Marian
中科院分区：
文献类型：
--
作者：
Owen, Anthony;Marven, Sean;Knight, Marian
背景：腹裂采用新的手术方法及其结果的信息在很大程度上仅限于基于医院的研究。本研究的目的是使用一种新的英国国家监测系统来识别病例，从而描述当代腹裂的手术处理和结果。方法：2006年10月至2008年3月，我们使用英国儿科外科医师协会先天性异常监测系统进行了一项全国性的队列研究，以确定病例。结果：英国和爱尔兰的28个外科单位全部参与(100%)。收到了95%的腹裂报告病例的数据(n=393)。单纯性腹裂336例(85.5%)，复杂型腹裂45例(11.5%)。12例(3.0%)腹裂类型不能归类。手术一期缝合(n=170，51%)和预成型筒仓后分期缝合(n=120，或36%)是治疗单纯性腹裂最常用的方法。尽管所有死亡病例都发生在单纯腹裂组，但患有复杂性腹裂的婴儿的预后明显比单纯腹裂差。结论：这项研究全面介绍了英国目前腹裂手术治疗的实践。进一步的随访数据将有助于阐明其他预后因素，并指导未来的研究。(C)2010 Elsevier Inc.保留所有权利。
Background: Information on adoption of newer surgical strategies for gastroschisis and their outcomes is largely limited to hospital-based studies. The aim of this study was to use a new UK national surveillance system to identify cases and thus to describe the contemporary surgical management and outcomes of gastroschisis.Methods: We conducted a national cohort study using the British Association of Paediatric Surgeons Congenital Anomalies Surveillance System to identify cases between October 2006 and March 2008.Results: All 28 surgical units in the United Kingdom and Ireland participated (100%). Data were received for 95% of notified cases of gastroschisis (n = 393). Three hundred thirty-six infants (85.5%) had simple gastroschisis; 45 infants (11.5%) had complex gastroschisis. For 12 infants (3.0%), the type of gastroschisis could not be categorized. Operative primary closure (n = 170, or 51%) and staged closure after a preformed silo (n = 120, or 36%) were the most commonly used intended techniques for simple gastroschisis. Outcomes for infants with complex gastroschisis were significantly poorer than for simple cases, although all deaths occurred in the simple group.Conclusions: This study provides a comprehensive picture of current UK practice in the surgical management of gastroschisis. Further follow-up data will help to elucidate additional prognostic factors and guide future research. (C) 2010 Elsevier Inc. All rights reserved.