Chiara C M M Lap1, Maria L Brizot2, Lourens R Pistorius3, William L M Kramer4, Ivo B Teeuwen5, Marinus J Eijkemans6, Hens A A Brouwers7, Eva Pajkrt8, Anton H van Kaam9, Phebe N Adama van Scheltema10, Alex J Eggink11, Arno F van Heijst12, Monique C Haak13, Mirjam M van Weissenbruch14, Christien Sleeboom15, Christine Willekes16, Mark A van der Hoeven17, Ernst L van Heurn18, Catherina M Bilardo19, Peter H Dijk20, Robertine van Baren21, Rossana P V Francisco22, Ana C A Tannuri23, Gerard H A Visser24, Gwendolyn T R Manten25. 1. University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Utrecht, The Netherlands.. Electronic address: c.c.m.m.lap@umcutrecht.nl. 2. Department of Obstetrics and Gynaecology, Hospital das Clínicas, São Paulo University Medical School, São Paulo, SP, Brazil.. Electronic address: mlbrizot@uol.com.br. 3. University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Utrecht, The Netherlands.; University of Stellenbosch, Department of Obstetrics and Gynaecology, Stellenbosch, South Africa.. Electronic address: lou@maternalfetal.co.za. 4. University Medical Center Utrecht, Department of Paediatric Surgery, Utrecht, The Netherlands.. Electronic address: wlm.kramer@solcon.nl. 5. Maastricht University Medical Center+, Department of Anesthesiology, Maastricht, The Netherlands.. Electronic address: i.b.teeuwen@gmail.com. 6. University Medical Center Utrecht, Biostatistics and Research Support, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.. Electronic address: M.J.C.Eijkemans@umcutrecht.nl. 7. University Medical Center Utrecht, Division Woman and Baby, Department of Neonatology, Utrecht, The Netherlands.. Electronic address: H.A.A.Brouwers@umcutrecht.nl. 8. Academic Medical Center Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands.. Electronic address: e.pajkrt@amc.uva.nl. 9. Emma Children's Hospital, Academic Medical Center Amsterdam, Department of Neonatology, Amsterdam, The Netherlands.. Electronic address: a.h.vankaam@amc.uva.nl. 10. Leiden University Medical Center, Department of Obstetrics and Gynaecology, Leiden, The Netherlands.. Electronic address: P.N.Adama_van_Scheltema@lumc.nl. 11. Radboud University Medical Center, Department of Obstetrics and Gynaecology, Nijmegen, The Netherlands.; Erasmus MC University Medical Centre Rotterdam, Department of Obstetrics and Gynaecology, Rotterdam, The Netherlands.. Electronic address: a.eggink@erasmusmc.nl. 12. Radboud University Medical Center, Department of Neonatology, Nijmegen, The Netherlands.. Electronic address: arno.vanheijst@erasmusmc.nl. 13. Leiden University Medical Center, Department of Obstetrics and Gynaecology, Leiden, The Netherlands.; VU University Medical Center Amsterdam, Department of Obstetrics and Gynaecology, Amsterdam, The Netherlands.. Electronic address: mc.haak@xs4all.nl. 14. VU University Medical Center Amsterdam, Department of Neonatology, Amsterdam, The Netherlands.. Electronic address: M.vanWeissenbruch@vumc.nl. 15. Pediatric Surgical Center of Amsterdam, Emma Children's Hospital University Medical Center and VU Medical Center, Amsterdam, the Netherlands.. Electronic address: Chr.Sleeboom@vumc.nl. 16. Maastricht University Medical Center+, Department of Obstetrics and Gynaecology, Maastricht, The Netherlands.. Electronic address: c.willekes@mumc.nl. 17. Maastricht University Medical Center+, Department of Neonatology, Maastricht, The Netherlands.. Electronic address: m.vander.hoeven@mumc.nl. 18. Maastricht University Medical Center+, Department of Paediatric Surgery, Maastricht, The Netherlands.; Pediatric Surgical Center of Amsterdam, Emma Children's Hospital University Medical Center and VU Medical Center, Amsterdam, The Netherlands.. Electronic address: e.vanheurn@amc.nl. 19. University Medical Center Groningen, Department of Obstetrics and Gynaecology, Groningen, The Netherlands.. Electronic address: c.m.bilardo@umcg.nl. 20. University Medical Center Groningen, University of Groningen, Department of Neonatology Beatrix Children's Hospital, Groningen, The Netherlands.. Electronic address: p.h.dijk@umcg.nl. 21. University Medical Center Groningen, University of Groningen, Department of Paediatric Surgery, Groningen, The Netherlands.. Electronic address: r.van.baren@chir.umcg.nl. 22. Department of Obstetrics and Gynaecology, Hospital das Clínicas, São Paulo University Medical School, São Paulo, SP, Brazil.. Electronic address: rossana.francisco@hc.fm.usp.br. 23. Department of Pediatric, Pediatric Surgery Division, São Paulo University Medical School, São Paulo, SP, Brazil. 24. University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Utrecht, The Netherlands.. Electronic address: G.H.A.Visser@umcutrecht.nl. 25. University Medical Center Utrecht, Division Woman and Baby, Department of Obstetrics, Utrecht, The Netherlands.. Electronic address: G.T.R.Manten@umcutrecht.nl.
Abstract
OBJECTIVE: To determine outcome of children born with isolated gastroschisis (no extra-gastrointestinal congenital abnormalities). STUDY DESIGN: International cohort study and meta-analysis. PRIMARY OUTCOME: time to full enteral feeding (TFEF); secondary outcomes: Duration of mechanical ventilation, length of stay (LOS), mortality and differences in outcome between simple and complex gastroschisis (complex; born with bowel atresia, volvulus, perforation or necrosis). To compare the cohort study results with literature three databases were searched. Studies were eligible for inclusion if cases were born in developed countries with isolated gastroschisis after 1990, number of cases >20 and TFEF was reported. RESULTS: The cohort study included 204 liveborn cases of isolated gastroschisis. The TFEF, median duration of ventilation and LOS was, 26days (range 6-515), 2days (range 0-90) and 33days (range 11-515), respectively. Overall mortality was 10.8%. TFEF and LOS were significantly longer (P<0.0001) and mortality was fourfold higher in the complex group. Seventeen studies, amongst the current study, were included for further meta-analysis comprising a total of 1652 patients. Mean TFEF was 35.3±4.4days, length of ventilation was 5.5±2.0days, LOS was 46.4±5.2days and mortality risk was 0.06 [0.04-0.07 95%CI]. Outcome of simple and complex gastroschisis was described in five studies. TFEF, ventilation time, LOS were significant longer and mortality rate was 3.64 [1.95-6.83 95%CI] times higher in complex cases. CONCLUSIONS: These results give a good indication of the expected TFEF, ventilation time and LOS and mortality risk in children born with isolated gastroschisis, although ranges remain wide. This study shows the importance of dividing gastroschisis into simple and complex for the prediction of outcome.
OBJECTIVE: To determine outcome of children born with isolated gastroschisis (no extra-gastrointestinal congenital abnormalities). STUDY DESIGN: International cohort study and meta-analysis. PRIMARY OUTCOME: time to full enteral feeding (TFEF); secondary outcomes: Duration of mechanical ventilation, length of stay (LOS), mortality and differences in outcome between simple and complex gastroschisis (complex; born with bowel atresia, volvulus, perforation or necrosis). To compare the cohort study results with literature three databases were searched. Studies were eligible for inclusion if cases were born in developed countries with isolated gastroschisis after 1990, number of cases >20 and TFEF was reported. RESULTS: The cohort study included 204 liveborn cases of isolated gastroschisis. The TFEF, median duration of ventilation and LOS was, 26days (range 6-515), 2days (range 0-90) and 33days (range 11-515), respectively. Overall mortality was 10.8%. TFEF and LOS were significantly longer (P<0.0001) and mortality was fourfold higher in the complex group. Seventeen studies, amongst the current study, were included for further meta-analysis comprising a total of 1652 patients. Mean TFEF was 35.3±4.4days, length of ventilation was 5.5±2.0days, LOS was 46.4±5.2days and mortality risk was 0.06 [0.04-0.07 95%CI]. Outcome of simple and complex gastroschisis was described in five studies. TFEF, ventilation time, LOS were significant longer and mortality rate was 3.64 [1.95-6.83 95%CI] times higher in complex cases. CONCLUSIONS: These results give a good indication of the expected TFEF, ventilation time and LOS and mortality risk in children born with isolated gastroschisis, although ranges remain wide. This study shows the importance of dividing gastroschisis into simple and complex for the prediction of outcome.
Authors: Erin A Plummer; Qi Wang; Catherine M Larson-Nath; Johannah M Scheurer; Sara E Ramel Journal: Early Hum Dev Date: 2018-12-17 Impact factor: 2.079
Authors: Russell B Hawkins; Steven L Raymond; Shawn D St Peter; Cynthia D Downard; Faisal G Qureshi; Elizabeth Renaud; Paul D Danielson; Saleem Islam Journal: J Pediatr Surg Date: 2019-08-22 Impact factor: 2.545
Authors: C C M M Lap; L R Pistorius; E J H Mulder; M Aliasi; W L M Kramer; C M Bilardo; T E Cohen-Overbeek; E Pajkrt; D Tibboel; R M H Wijnen; G H A Visser; G T R Manten Journal: Ultrasound Obstet Gynecol Date: 2020-06 Impact factor: 7.299