Closing arguments for gastroschisis: Management with silo reduction

Bill Chiu, John Lopoo, J. David Hoover, P. Stephen Almond, Robert Arensman, Mary Beth Madonna*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

22 Scopus citations

Abstract

Background: There are two approaches to close gastroschisis. Primary closure (PC) is reduction and fascial closure; silo closure (SC) places viscera in a preformed-silo and reduces the contents overtime. We have shifted from PC to SC. This study compared the outcomes of these two techniques. Methods: Records of babies with gastroschisis from 1994-2004 were reviewed. Closure type, ventilator days, days to full-feeds, hospital days, complications, and mortality were recorded. Results: Twenty-eight patients underwent PC; 20 patients had SC. Differences in ventilator days, days to full-feeds, and hospital days were not statistically significant. Nine PC patients developed closure-related complications vs. none in SC (P < 0.05). Eight PC vs. two SC patients had non-closure-related complications (P < 0.05). Four PC vs. zero SC patients developed necrotizing enterocolitis (P < 0.05). Five PC vs. one SC patients had ventral hernia (P < 0.05). No patient died. Conclusion: PC resulted in higher incidence of reclosure, non-closure-related complications, and necrotizing enterocolitis. Consequently, we recommend SC as the preferred treatment.

Original languageEnglish (US)
Pages (from-to)243-245
Number of pages3
JournalJournal of Perinatal Medicine
Volume34
Issue number3
DOIs
StatePublished - May 1 2006

Keywords

  • Gastroschisis
  • Silo

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

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