Binet A, Scalabre A, Amar S, Alzahrani K, Boureau C, Bastard F, Lefebvre F, Koffi M, Moufidath S, Nasser D, Ouattara O, Kouame B D, Lardy H
Visceral Pediatric Surgery Unit, University Hospital Centre of Tours, Gatien de Clocheville Hospital, 37000 Tours, France.
Visceral Pediatric Surgery Unit, University Hospital Centre of Saint-Etienne, 42270 Saint-Étienne, France.
Ann Chir Plast Esthet. 2020 Apr;65(2):147-153. doi: 10.1016/j.anplas.2019.03.004. Epub 2019 Apr 30.
The giant omphalocele is currently a surgical challenge. The morbidity and mortality associated with its care is non-negligible. Nowadays, different studies have revived the debate between conservative and surgical management for giant omphalocele. The purpose of this study is to compare the conservative and surgical management of the giant omphalocele in terms of morbidity and mortality.
Retrospective study including all giant omphaloceles comparing surgical management (French University hospital centers) and tanning (Ivory Coast University hospital center). Epidemiology was studied as well as medical and surgical managements both intra and post operative.
One hundred and forty-seven patients included (98 patients in the "tanning" group and 49 in the "surgery" group). Hospital length of stay is significantly shorter in the "tanning" group as they do not spend time in intensive care unit. Morbidity is higher in "surgery" group. The average duration for oral empowerment was acquired at 179 days in the "surgery" group, whereas in the "tanning" group 90% was immediately and exclusively breastfed. No significant differences in terms of epithelialization time.
The tanning treatment has its own place in the therapeutic arsenal in the management of the giant omphalocele no matter where it takes place. However, its realization in surgical environments prevents certain complications related to the technique or the pathology.
巨大脐膨出目前是一项外科挑战。与其治疗相关的发病率和死亡率不可忽视。如今，不同研究重新引发了关于巨大脐膨出保守治疗与手术治疗的争论。本研究的目的是在发病率和死亡率方面比较巨大脐膨出的保守治疗和手术治疗。
回顾性研究纳入所有巨大脐膨出病例，比较手术治疗（法国大学医院中心）和包扎治疗（科特迪瓦大学医院中心）。对流行病学以及术前和术后的医疗与手术管理进行了研究。
共纳入147例患者（“包扎”组98例，“手术”组49例）。“包扎”组的住院时间显著更短，因为他们无需在重症监护病房停留。“手术”组发病率更高。“手术”组经口喂养平均在179天实现，而“包扎”组90%立即且完全采用母乳喂养。上皮化时间无显著差异。
无论在何处进行，包扎治疗在巨大脐膨出的治疗手段中都有其自身的地位。然而，在手术环境中实施包扎治疗可预防某些与技术或病理相关的并发症。
