Epidemiology, University of Antioquia, Medellin, Colombia.
North University (Universidad del Norte-Uninorte), Barranquilla, Colombia.
Sci Rep. 2021 Jan 11;11(1):310. doi: 10.1038/s41598-020-78991-y.
No studies of the efficacy and safety of surgical techniques for the primary closure of giant omphalocele have been performed in Colombia. To determine the mortality rate and factors associated with mortality in neonates with giant omphalocele subjected to the surgical technique of early closure with a surgical silo described by Abello in Barranquilla, Colombia from 1994 to 2019. Retrospective cohort study of 30 neonates diagnosed with giant omphalocele and subjected to early closure of the defect. Medical history data were collected, information bias was controlled for, and descriptive statistical analysis was performed using Fisher's exact test and the Mann-Whitney U test in SPSS 25.0. Of the patients in the cohort, 36.7% presented technique-related complications, 56.7% developed sepsis, 23.3% had low birth weight, 26.7% were preterm births, 43.3% had other malformations, 26.7% had congenital heart defects, and 13.3% presented pulmonary hypertension. The mean hospital stay was 26 days. The mortality rate was 16.7%; it was significantly higher among patients with other malformations, congenital heart defects, pentalogy of Cantrell and pulmonary hypertension. The Abello technique for the treatment of giant omphalocele showed a high neonatal survival rate and a low rate of procedure-related complications. The main factors associated with the death of neonatal patients were the presence of other malformations, congenital heart defect, pentalogy of Cantrell and pulmonary hypertension.
在哥伦比亚,尚未开展过针对巨大脐膨出的一期缝合手术技术的疗效和安全性研究。本研究旨在确定在哥伦比亚巴兰基亚由 Abello 描述的手术吊袋早期闭合手术技术治疗巨大脐膨出的新生儿的死亡率和与死亡率相关的因素。这是一项回顾性队列研究,纳入了 1994 年至 2019 年间被诊断为巨大脐膨出并接受早期缺陷闭合的 30 例新生儿。收集了病史数据,控制了信息偏倚,并使用 SPSS 25.0 中的 Fisher 确切检验和 Mann-Whitney U 检验进行描述性统计分析。队列中的患者中,36.7%出现与技术相关的并发症,56.7%发生脓毒症,23.3%出生体重低,26.7%早产,43.3%有其他畸形,26.7%有先天性心脏缺陷,13.3%患有肺动脉高压。平均住院时间为 26 天。死亡率为 16.7%;存在其他畸形、先天性心脏缺陷、Cantrell 五联征和肺动脉高压的患者死亡率显著更高。Abello 技术治疗巨大脐膨出显示出较高的新生儿存活率和较低的手术相关并发症发生率。与新生儿患者死亡相关的主要因素是存在其他畸形、先天性心脏缺陷、Cantrell 五联征和肺动脉高压。