Department of Surgery, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
Department of Surgery, Surgical NICU, Instituto Fernandes Figueira - Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil.
J Pediatr Surg. 2020 Aug;55(8):1546-1551. doi: 10.1016/j.jpedsurg.2020.04.011. Epub 2020 Apr 29.
BACKGROUND/PURPOSE: Gastroschisis is increasing in incidence and has low mortality and high morbidity. We describe the clinical and surgical characteristics of gastroschisis patients in a Brazilian referral center.
Single-center prospective case series of gastroschisis patients. The following two groups were formed depending on the intestinal characteristics: simple and complex patients.
In total, 79 patients were enrolled, 89% of whom were classified as simple and 11% as complex. The baseline characteristics were similar between the groups, with the exception of the illness severity score. The complex group had a significantly smaller defect size, more reoperations and worse clinical outcomes than the simple group, with the initiation of feeding taking 1.5 times longer, the duration of total parenteral nutrition taking twice as long, and the length of hospitalization being 2.5 times longer; the complex group also included all the deaths that occurred. Overall, the survival rate was 96%. Patients who underwent the sutureless technique had significantly fewer wound infections and a decreased duration of mechanical ventilation than sutured patients.
This study provides a comprehensive picture of gastroschisis during the neonatal period in a Brazilian referral center, emphasizing the significantly higher risk for morbidity and mortality among complex patients than among simple patients and the few advantages of the sutureless technique over the sutured technique in terms of closing the defect.
Prognostic.
IV.
背景/目的：先天性腹裂的发病率正在上升，其死亡率低，发病率高。我们描述了巴西一家转诊中心先天性腹裂患者的临床和手术特征。
对先天性腹裂患者进行单中心前瞻性病例系列研究。根据肠的特征将患者分为两组：简单型和复杂型。
共纳入 79 例患者，其中 89%为简单型，11%为复杂型。两组的基线特征相似，除疾病严重程度评分外。与简单组相比，复杂组的缺陷尺寸更小，需要更多的手术和更差的临床结局，开始喂养的时间延长了 1.5 倍，全胃肠外营养的持续时间延长了 2 倍，住院时间延长了 2.5 倍；复杂组还包括所有死亡病例。总体而言，存活率为 96%。与缝合组相比，采用无缝合技术的患者的伤口感染明显减少，机械通气时间缩短。
本研究全面描述了巴西一家转诊中心新生儿期先天性腹裂的情况，强调了复杂型患者的发病率和死亡率明显高于简单型患者，并且无缝合技术在关闭缺陷方面比缝合技术具有更少的优势。
预后。
IV。
