The influence of the eventrated viscera injuries on viscero-abdominal disproportion degree in simple gastroschisis
Keywords:
gastroschisis, eventrated viscera injuries, viscero-abdominal disproportion, surgical treatmentAbstract
Eventrated viscera injuries in gastroschisis (GS) lead to postoperative motility disturbance, increase the length of hospital stay and mortality, however, their influence on the degree of viscero-abdominal disproportion (VAD) has not been sufficiently studied.Aim of the study. To investigate the effect of eventrated viscera injuries on the degree of VAD in simple gastroschisis.
Materials and methods. This study enrolled 107 infants with simple GS that underwent surgical management at SI «Institute of Pediatrics, Obstetrics and Gynecology named after academician O. Lukyanova of the National Academy of Medical Sciences of Ukraine (n=84) and Mykolaiv Regional Children's Clinical Hospital (n=23) for the period from 1987 to 2019. Group 1 enrolled the patients without bowel damage (17.8%; n=19). Group 2 included the newborns with moderate bowel injuries (33.6%; n=36). The children from group 3 showed severe affected eventrated viscera (48.6%; n=52).
Results. No significant difference in the incidence of absent and moderate VAD was found (31.5% vs. 68.4%; p=0.12) among the patients without bowel damage. A severe VAD was not diagnosed among the patients of this group. The absence of VAD and its severe degree were observed with the same rate (13.9%) among the newborns with moderate bowel injuries, however, a moderate VAD was diagnosed significantly more often (13.9% vs. 72.2%; p=0.001). The absence of VAD wasn't observed among the children who had severe affected eventrated viscera, and no significant difference in the frequency of moderate and severe VAD was found (40.4% versus 59.6%; p=0.15).
Conclusion. The severity of eventrated viscera injuries in simple gastroschisis has a decisive influence on the development of viscero-abdominal disproportion and its degree.
Level of evidence. Level III.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of all participating institution. The informed consent of the patient was obtained for conducting the studies.
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