TY - JOUR

T1 - Surgical Management of Congenital Abdominal Wall Defects in Germany

T2 - A Population-Based Study and Comparison with Literature Reports

AU - Dingemann, Carmen

AU - Dietrich, Janine

AU - Zeidler, Jan

AU - Blaser, Jochen

AU - Gosemann, Jan Hendrik

AU - Lacher, Martin

AU - Ure, Benno

N1 - Publisher Copyright: © 2017 Georg Thieme Verlag KG Stuttgart New York. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.

PY - 2017/12/1

Y1 - 2017/12/1

N2 - Introduction We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports. Patients and Methods Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment. Results Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p = 0.003) and hospitalization (p < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study. Conclusion Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.

AB - Introduction We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports. Patients and Methods Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment. Results Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p = 0.003) and hospitalization (p < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study. Conclusion Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.

KW - abdominal wall defect

KW - gastroschisis

KW - neonatal

KW - omphalocele

KW - pediatric surgery

UR - http://www.scopus.com/inward/record.url?scp=85013957692&partnerID=8YFLogxK

U2 - 10.1055/s-0037-1598250

DO - 10.1055/s-0037-1598250

M3 - Article

C2 - 28235205

AN - SCOPUS:85013957692

VL - 27

SP - 516

EP - 525

JO - European Journal of Pediatric Surgery

JF - European Journal of Pediatric Surgery

SN - 0939-7248

IS - 6

ER -