Emil Sherif
Department of Pediatric Surgery; The Montreal Children's Hospital, McGill University Health Centre, Room B04.2028, 1001 Decarie Boulevard, Montreal, QC, Canada H4A 3J1.
Semin Pediatr Surg. 2018 Oct;27(5):309-315. doi: 10.1053/j.sempedsurg.2018.08.003. Epub 2018 Aug 25.
Currently, the most important determinant of gastroschisis outcomes in high resource settings is whether the condition is associated with intestinal complications, such as atresia, necrosis, perforation, or volvulus. This form of the anomaly, known as complex gastroschisis, accounts for most of the mortality and a disproportionate burden of the morbidity from gastroschisis. There is some disagreement about what constitutes complex gastroschisis, and little consensus on the type and timing of surgical interventions. This article establishes a clear definition of complex gastroschisis. Surgical approaches to treatment of the diverse presentations of complex gastroschisis will be described and the timing of such interventions will be discussed. Contemporary outcomes of complex gastroschisis will be reviewed. Finally, a non-congenital intestinal complications that may arise in gastroschisis patients will be discussed.
目前，在资源丰富的环境中，腹裂预后的最重要决定因素是该病症是否伴有肠道并发症，如闭锁、坏死、穿孔或肠扭转。这种形式的异常被称为复杂性腹裂，占腹裂死亡率的大部分，且在发病率方面造成了不成比例的负担。对于什么构成复杂性腹裂存在一些分歧，对于手术干预的类型和时机也几乎没有共识。本文确立了复杂性腹裂的明确定义。将描述针对复杂性腹裂不同表现的手术治疗方法，并讨论此类干预的时机。将回顾复杂性腹裂的当代预后情况。最后，将讨论腹裂患者可能出现的非先天性肠道并发症。
