Schier F, Schier C, Stute M P, Würtenberger H
Klinik für Kinderchirurgie, Westfälischen, Wilhelms-Universität Münster.
Zentralbl Chir. 1988;113(4):225-34.
Treatment was applied to 97 cases of omphalocele and 96 cases of gastroschisis at the Dortmund Department of Paediatric Surgery over the past 20 years. The survival rate was 122. Follow-up checks were recently applied to 56 of those former patients, after nearly ten years had elapsed from surgery. Thirty-eight of these patients were clinically examined, while questionnaires were completed for the rest. Primary closures had been performed on 50 per cent of the cases, while the defects in the other children were closed in two stages, using dura implantation or silastic pouches, or were conservatively treated. Accompanying malformations were recorded from 21 per cent of the gastroschisis cases and from 28 per cent of those with omphalocele. Overall mortality accounted for 37 per cent, with mortality in the wake of receptive operations being as high as 40 to 50 per cent, the latter rate not depending on the primary approach. One and the same risk was found to exist for conservative treatment (applicable only to closed omphalocele) and primary surgical closure, as may be seen from statistical evaluation. The highest rate of relaparotomy occurred in the wake of dura implantation and use of silastic pouches.
在过去20年里,多特蒙德儿科外科对97例脐膨出患儿和96例腹裂患儿进行了治疗。存活率为122。在手术近十年后,最近对其中56名 former patients进行了随访检查。其中38名患者接受了临床检查,其余患者填写了问卷。50%的病例进行了一期缝合,其他患儿的缺损则分两期闭合,采用硬脑膜植入或硅橡胶袋,或进行保守治疗。21%的腹裂病例和28%的脐膨出病例记录有伴随畸形。总死亡率为37%,接受性手术后的死亡率高达40%至50%,后者的发生率与初始手术方式无关。从统计评估中可以看出,保守治疗(仅适用于闭合性脐膨出)和一期手术缝合存在相同的风险。硬脑膜植入和使用硅橡胶袋后再次剖腹手术的发生率最高。