A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town

[摘要] ENGLISH ABSTRACT: BackgroundThe incidence of gastroschisis (GS) is rising and the outcomes in low to middle income countries are believed to be poor. Many studies from developed countries have evaluated prognostic factors and outcomes of GS, however there is little data from the developing world.AimTo determine the outcome of neonates treated for GS in a tertiary neonatal service in South Africa.MethodsA retrospective case series of neonates admitted from January 2004 to July 2015 to the neonatal intensive care unit (NICU) at Tygerberg Children's Hospital, Western Cape was conducted. Of the 39 cases, full clinical data was available for 31. All had surgery (primary closure or silo placement with delayed closure) and initial total parenteral nutrition (TPN). Main outcomes assessed were mortality rate, sepsis rate, time to full enteral feeding, occurrence of bowel related complications and the development of parenteral nutrition associated cholestasis (PNAC).ResultsOf the 31 neonates with GS, five (16%) cases were complex GS. Two (6.4%) neonates died. The culture proven sepsis rate was 46% and overwhelming infection was the most common cause of death. Seventy-one percent had no bowel related complications and the majority (67%) achieved full enteral feeding by 21 days. Six (24%) developed PNAC.ConclusionThe outcome of GS in a single center tertiary hospital is comparable to that in high-income countries. The mortality and bowel complication rate is low, however there is a high rate of sepsis. To reduce mortality, strict infection prevention control is mandatory.

[发布机构] Stellenbosch University