Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 May;209(5):901-5; discussion 905-6.
doi: 10.1016/j.amjsurg.2015.01.012. Epub 2015 Feb 24.

Contemporary trends in the use of primary repair for gastroschisis in surgical infants

Patrick M Chesley  1 , Daniel J Ledbetter  2 , John J Meehan  2 , Assaf P Oron  3 , Patrick J Javid  4
Affiliations

Contemporary trends in the use of primary repair for gastroschisis in surgical infants

Patrick M Chesley et al. Am J Surg. 2015 May.

Abstract

Background: Gastroschisis is a newborn anomaly requiring emergent surgical intervention. We review our experience with gastroschisis to examine trends in contemporary surgical management.

Methods: Infants who underwent initial surgical management of gastroschisis from 1996 to 2014 at a pediatric hospital were reviewed. Closure techniques included primary fascial repair using suture or sutureless umbilical closure, and staged repair using sutured or spring-loaded silo (SLS). Data were separated into 3 clinical eras: pre-SLS (1996 to 2004), SLS (2005 to 2008), and umbilical closure (2009 to 2014).

Results: In the pre-SLS era, 60% (34/57) of infants with gastroschisis underwent primary repair. With the advent of SLS, there was a decrease in primary repair (15%, 10/68, P < .0001). Following introduction of sutureless umbilical closure, 61% (47/77) of infants have undergone primary repair. On multivariate regression, primary repair was associated with shorter intensive care unit stays (P < .001) and time to initiate enteral nutrition (P < .01).

Conclusions: Following introduction of a less invasive technique for gastroschisis repair, most infants with gastroschisis were able to be repaired primarily. Primary repair should be considered in all babies with gastroschisis and favorable anatomy.

Keywords: Complicated gastroschisis; Gastroschisis; Spring-loaded silo; Umbilical sutureless closure.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Percent of primary versus delayed closure by era.
Figure 2
Figure 2
In the most recent clinical era, the majority of babies with gastroschisis have been repaired with primary closure and the frequency of primary closure continues to increase.
See this image and copyright information in PMC

References

    1. Sandler A, Lawrence J, Meehan J, et al. A “plastic” sutureless abdominal wall closure in gastroschisis. J Pediatr Surg. 2004;39:738–41. - PubMed
    1. Riboh J, Abrajano C, Garber K, et al. Outcomes of sutureless gastroschisis closure. J Pediatr Surg. 2009;44:1947–51. - PubMed
    1. Weinsheimer R, Yanchar N, Bouchard S, et al. Gastroschisis closure—does method really matter? J Pediatr Surg. 2008;43:874–8. - PubMed
    1. Choi WW, McBride CA, Bourke C, et al. Long-term review of suture-less ward reduction in neonates with gastroschisis in the neonatal unit. J Pediatr Surg. 2012;47:1516–20. - PubMed
    1. Snyder C. Outcome analysis for gastroschisis. J Pediatr Surg. 1999;34:1253–6. - PubMed

Publication types

LinkOut - more resources