Surgical management of gastroschisis in North Queensland from 1988 to 2007
Surgical management of gastroschisis in North Queensland from 1988 to 2007
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DOI：
10.1111/j.1440-1754.2009.01615.x
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发表时间：
2010-01-01
影响因子：
1.7
通讯作者：
Stalewski, H.
中科院分区：
文献类型：
--
作者：
Kandasamy, Yoga;Whitehall, John;Stalewski, H.
目的：回顾1988-2007年发生在北昆士兰州并在汤斯维尔的新生儿中心修复的腹裂的结局，并将这些结局与其他中心发表的数据进行比较。方法：对手术室内筋膜层伤口闭合的初次手术修复（POR）后结局的回顾性图表审查，在病房内进行脐带贴附和粘性敷料的一期非手术修复（PNOR），筒仓后的二期修复（SR），以及阻塞、穿孔或闭锁病例的复杂修复（CR）。来自北昆士兰州但在布里斯班管理的婴儿的流行病学数据从Mater Mothers' Hospital和皇家儿童医院获得。结果：在汤斯维尔治疗了50例病例：PNOR治疗16例，POR治疗22例，SR治疗6例，CR治疗6例。PNOR、POR和SR治疗的无并发症病例的结局相似。CR后并发症患者的预后明显较差。Townsvillle的PNOR与四个海外单位SR后发表的结果之间无显著差异。未发现先天婴儿和外生婴儿、阴道分娩或剖腹产婴儿以及土著婴儿和非土著婴儿之间的结果存在差异。3人（6%）死亡。腹裂在北昆士兰州不断增加，尤其是在年轻母亲中。土著母亲的发病率高2-3倍。结论：PNOR和其他技术之间没有显着差异，发现简单的情况下。PNOR避免了使用手术室和工作人员，减少了延误和成本，以及运送生病婴儿的需要。
Aim: To review outcomes of gastroschises originating in North Queensland and repaired in the neonatal centre in Townsville from 1988-2007, and compare these outcomes with published data from other centres.Methods: A retrospective chart review of outcomes after primary operative repair (POR) with wound closure in fascial layers in the theatre, primary non-operative repair (PNOR) with apposition of the umbilical cord and adhesive dressing in the ward, secondary repair (SR) after a silo, and complex repair (CR) of cases with obstruction, perforation or atresiae. Epidemiological data of babies originating in North Queensland but managed in Brisbane were secured from Mater Mothers' Hospital and the Royal Hospital for Children.Results: Fifty cases were treated in Townsville: 16 by PNOR, 22 by POR, 6 by SR and 6 by CR. Outcomes of uncomplicated cases treated by PNOR, POR and SR were similar. Outcomes of complicated cases after CR were significantly worse. No significant differences were found between PNOR in Townsvillle and published outcomes after SR from four overseas units. No differences were detected in outcomes of inborn and outborn babies, those delivered by vaginal or caesarean birth or between indigenous and non-indigenous babies. Three (6%) died. Gastroschisis is increasing in North Queensland, particularly in younger mothers. The incidence is 2-3 times higher in indigenous mothers.Conclusion: No significant differences were found between PNOR and other techniques for uncomplicated cases. PNOR avoids the use of theatre and staff, reducing delay and cost, and the need to transport a sick baby.