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The results of the «first minutes surgery» in the treatment of gastroschisis

PERINATOLOGIYA I PEDIATRIYA.2014.4(60):18–23;doi10.15574/PP.2014.60.18

The results of the «first minutes surgery» in the treatment of gastroschisis

A.K. Slepov, N.I. Grasyukova, V.L. Veselskiy

 

SI «Institute of Pediatrics, Obstetrics and Gynecology, NAMS of Ukraine», Kiev, Ukraine

 

Object – to examine the results of the «first minutes surgery» in the treatment of gastroschisis based on a comparative analysis with traditional methods of surgical correction of this defect.

 

Patients and methods. Analyzed the medical records (n=87) and autopsy protocols (n=43) in 87 newborns with gastroschisis for the period 1987–2013yy. The 43 children from them had died without (n=4), or after surgery (n=39). Newborns with gastroschisis were divided into three clinical groups depending to the prenatal diagnosis conduction and clinical examination of the fetus with gastroschisis, mode of delivery and transportation, location, period and nature of surgical treatment. There are used the following methods: clinical, radiological (plain adiography of the chest and abdomen, radiographic contrast study of the gastrointestinal tract (passage, irrigography – with the use of water – soluble iodinated substances)); ultrasonographic examination: of abdominal cavity and retroperitoneal space, echocardiography, neurosonography, morphological and histological methods (during the autopsy of died children) and statistical.

 

Results. During the «first minute surgery» were established the significantly lower rates, such as: duration of the operation, the number of postoperative complications and postoperative mortality rate. In the postoperative period of survived children is pronounced shorter duration of mechanical ventilation, earlier resumption of motility of the gastrointestinal tract: the appearance of an active intestinal peristalsis, lack of gastric stasis, self-discharge of the feces and the introduction of partial and full enteral nutrition. At the same time the overall hospital stay was reduced.

 

Conclusions. During the comparative analysis of the results of surgical treatment of gastroschisis in newborn infants of the different clinical groups were revealed irrefutable positive benefits of the «first minutes surgery» over the traditional methods of treatment of this defect.

 

Kay words: gastroschisis, «first minutes surgery» immediate results, newborns.

 

 

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