Survival Rate in Patients with Gastroschisis and Prognostic Factors Affected

Abstract

Background & aim: The research shows the experience of the children's hospital in the management of patients with gastroschisis and identification of morbidity and mortality،  as well as determining the prognostic factors that affect the survival rate as a step to improve the prognosis in the future،  and then compare the results with some international studies.

Methods: A retrospective study of patients with gastroschisis admitted to the Children Hospital of Damascus and underwent surgical intervention during 10 years between January 2000 and end of December2010.
Results: 70 patients with gastroschisis were studied،  including 38 males and 32 females،  the number of preterm infants 18 and the mean birth weight was 2.48 kg،  the mean age of the mother was 22 years،  the caesarean section was 13 cases. The prenatal diagnosis done by US in 6 cases as the alpha-feto protein AFP never done.   Several congenital malformations،  such as intestinal atresia،  were observed in 4 cases and mesenteric cyst in one case. The management was primary closure of the abdominal wall in 7 cases and a phasing closure using a bag in 90% of cases. The mean age of the newborn at admission was 22 hours and the timing of surgical overlap exceeded this for many reasons. TPN was applied in 4 cases. Survival was 5 cases with 7% and deaths in 65 patients.

Conclusions: Death rates are still high in our study as developed countries have significantly improved prenatal and postoperative care،  the application of TPN and the new techniques used to manage these patients،  and we must actively seek to develop care for these neonates in order to improve the survival rate in the future.