Gastroschisis: What can the Neonate and Parents Expect?

I. Mc Donald1, M. Doyle2, J. Murphy1 

1. Department of Neonatology Temple St. Children’s University Hospital, Temple Street, Dublin 1
2. Department of Surgery Temple St. Children’s University Hospital, Dublin 1

Dear Sir,

Gastroschisis is a congenital anomaly characterised by a full thickness abdominal wall defect through which abdominal viscera, not covered by a protective sac, protrude1. It is a surgical emergency and patients are transferred to a tertiary surgical centre. Inpatient stay is of variable length post-surgical repair and involves central venous access, total parental nutrition(TPN) and establishing full oral feeds.

There was a retrospective observational study was evaluating neonates with gastroschisis admitted to a tertiary children’s’ surgical centre from 2005-2017. Information was collected from patient records and included length of stay, gender, type of surgical procedure, surgical resection or volvulus of bowel, day of life of surgical closure, TPN duration, time to full oral feeds, number of central access catheters and maternal age.

A total of 110 neonate’s medical records out of 136 were available for data collation.  The median length of stay was 47 days (1-135 days, SD: 24.8). The median length of TPN was 28 days (0-116) and the median length to full oral feeds was 34 days (11-134 days).  Thirty nine patients (35%) required two central venous catheters, while 3 patients (2.7%) required three. Eleven patients (10%) required a partial bowel resection. The average day of life of closure was 2 days (1-6 day of life). The average maternal age 24.2 years (15-36 years).

In conclusion, neonates with gastroschisis are complex patients that require a period of TPN, via central venous access, with a broad range to establish full oral feeds.  This is reflected in the long inpatient admission (median of 47 days). This study will help inform parents via an infographic of what to expect while their child is being cared for post gastroschisis closure.

Corresponding Author
Dr. Isobel Mc Donald,
Department of Neonatology,
Temple St Children’s University Hospital,
Ireland.
Email: isobelcmcdonald@gmail.com

References

  1. BucherBT, Mazotas IG, Warner BW, Saito JM. Effect of time to surgical evaluation on the outcomes of infants with gastroschisis. Journal of Pediatric Surgery. 2012Jun;47(6):1105-10.

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