Zajac Andrzej, Bogusz Bartosz, Soltysiak Piotr, Tomasik Przemyslaw, Wolnicki Michal, Wedrychowicz Andrzej, Wojciechowski Piotr, Gorecki Wojciech
Department of Pediatric Surgery, Collegium Medicum, Jagiellonian University, Krakow, Poland.
Department of Clinical Biochemistry, Collegium Medicum, Jagiellonian University, Krakow, Poland.
Eur J Pediatr Surg. 2016 Dec;26(6):537-541. doi: 10.1055/s-0035-1570759. Epub 2016 Jan 8.
A sutureless gastroschisis repair allows for spontaneous closure of abdominal wall defect. We report our experience focusing on final esthetic outcome. Retrospective data were collected from medical reports of all neonates with gastroschisis operated from January 2009 to December 2013. Variables recorded included patients descriptors, management modality, and cosmetic outcome. From the overall group of 38 patients with gastroschisis, 20 infants treated with sutureless closure were included in this study. In the analyzed cohort, 17 (85%) children were operated under general anesthesia and 3 (15%) without intubation. Primary reduction was possible in 15 (75%) cases, and in 5 (25%) we used silo. There were two (10%) deaths in late postoperative course due to septic complications. Three (15%) infants needed laparotomy because of adhesions and bowel obstruction. There were no infectious complications of the wound. Only 55% (10/18) of children presented umbilical hernia prior to discharge. Only two (11%) children with umbilical hernia were operated until now. Almost all patients (16/18; 89%) present excellent final cosmetic result without scar formation. Sutureless closure of uncomplicated gastroschisis is a safe technique that reduces need of intubation and provides excellent cosmetic results.
一种无缝合的腹裂修补术可使腹壁缺损自行闭合。我们报告我们在关注最终美学效果方面的经验。从2009年1月至2013年12月接受手术的所有腹裂新生儿的医学报告中收集回顾性数据。记录的变量包括患者描述、治疗方式和美容效果。在38例腹裂患者的总体中，本研究纳入了20例接受无缝合闭合治疗的婴儿。在分析的队列中，17例（85%）儿童在全身麻醉下手术，3例（15%）未插管。15例（75%）病例可行一期还纳，5例（25%）使用了腹腔袋。术后晚期因败血症并发症有2例（10%）死亡。3例（15%）婴儿因粘连和肠梗阻需要剖腹手术。伤口无感染并发症。仅55%（10/18）的儿童在出院前出现脐疝。到目前为止，只有2例（11%）有脐疝的儿童接受了手术。几乎所有患者（16/18；89%）呈现出极佳的最终美容效果且无瘢痕形成。无缝合闭合单纯性腹裂是一种安全的技术，可减少插管需求并提供极佳的美容效果。
