Outcome of management of gastroschisis: comparison of improvised surgical silo and extended right hemicolectomy

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Outcome of management of gastroschisis: comparison of improvised surgical silo and extended right hemicolectomy


JournalAnnals of Pediatric Surgery
Publication date – Jan – 2020
Authors – Philemon E. Okoro & Charles Ngaikedi
KeywordsClosure, Extended right hemicolectomy, Gastroschisis, Improvised silo, morbidity, mortality
Open access – Yes
SpecialityGeneral surgery, Paediatric surgery
World region Western Africa
Country: Nigeria
Language – English
Submitted to the One Surgery Index on May 12, 2020 at 4:49 am
Abstract:

Gastroschisis is onea of the major abdominal wall defects encountered commonly in pediatric surgery. Whereas complete reduction and abdominal closure is achieved easily sometimes, a daunting situation arises when the eviscerated bowel loops and other viscera cannot be returned immediately into the abdominal cavity. This situation is a major contributor to the outcome of the treatment of gastroschisis in our region. In our efforts to improve our outcome, we have adopted the technique of extended right hemicolectomy for cases where complete reduction and primary abdominal wall closure is otherwise not possible. This study compared the management outcome of gastroschisis using our improvised silo, and performing an extended right hemicolectomy.

Results
Thirty-nine cases were analyzed. Simple closure could not be achieved in 28 cases. In the absence of standard silos, improvised ones were constructed from the amniotic membrane (3 cases), urine bag (4 cases), and latex gloves (9 cases) giving a total of 16 cases managed with silos. Extended right hemicolectomy was performed in 12 cases.

Conclusions
Given the peculiarities of circumstances in our region regarding human and material resources in the care of gastroschisis patients, an extended right hemicolectomy, to make it possible to close the abdomen primarily in gastroschisis is a more viable option than the use of improvised silo.

OSI Number – 20353

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