de Buys Roessingh AS, Damphousse A, Ballabeni P, Dubois J, Bouchard S. Predictive factors at birth of the severity of gastroschisis. World J Gastrointest Pathophysiol 2015; 6(4): 228-234 [PMID: 26600981 DOI: 10.4291/wjgp.v6.i4.228]
Corresponding Author of This Article
Anthony S de Buys Roessingh, MD, PhD, Department of Biostatistic, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, CH -1011 Lausanne, Switzerland. anthony.debuys-roessingh@Chuv.ch
Research Domain of This Article
Pharmacology & Pharmacy
Article-Type of This Article
Basic Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pathophysiol. Nov 15, 2015; 6(4): 228-234 Published online Nov 15, 2015. doi: 10.4291/wjgp.v6.i4.228
Predictive factors at birth of the severity of gastroschisis
Anthony S de Buys Roessingh, Amélie Damphousse, Pierluigi Ballabeni, Josée Dubois, Sarah Bouchard
Anthony S de Buys Roessingh, Sarah Bouchard, Department of Pediatric Surgery, University Hospital, Hôpital Sainte-Justine, H3T1C5 Montréal, Canada
Amélie Damphousse, Josée Dubois, Department of Radiology, University Hospital, Hôpital Sainte-Justine, H3T1C5 Montréal, Canada
Anthony S de Buys Roessingh, Pierluigi Ballabeni, Department of Biostatistic, Centre Hospitalier Universitaire Vaudois, CH -1011 Lausanne, Switzerland
Author contributions: de Buys Roessingh AS and Bouchard S wrote the paper; Damphousse A and Dubois J did all the radiological lecture and Ballabeni P made the statistics.
Institutional review board statement: None.
Informed consent statement: All human studies have been reviewed by the appropriate ethics committee and all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study were omitted. Authors drew attention to the Code of Ethics of the World Medical Association (Declaration of Helsinki, 1964, as revised in 2004).
Conflict-of-interest statement: None of the authors have any financial or other relationships with other people or organizations that could inappropriately influence their work. There is no grant support for this research.
Data sharing statement: I declare data sharing statement in World Journal Gastrointestinal Pathophysiology; dataset available from the corresponding author at Email address or URL. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Anthony S de Buys Roessingh, MD, PhD, Department of Biostatistic, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 21, CH -1011 Lausanne, Switzerland. anthony.debuys-roessingh@Chuv.ch
Telephone: +41-21-3143126 Fax: +41-21-3143076
Received: June 5, 2015 Peer-review started: June 6, 2015 First decision: August 10, 2015 Revised: October 12, 2015 Accepted: October 23, 2015 Article in press: October 27, 2015 Published online: November 15, 2015 Processing time: 165 Days and 12.2 Hours
Abstract
AIM: To establish children born with gastroschisis (GS).
METHODS: We performed a retrospective study covering the period from January 2000 to December 2007. The following variables were analyzed for each child: Weight, sex, apgar, perforations, atresia, volvulus, bowel lenght, subjective description of perivisceritis, duration of parenteral nutrition, first nasogastric milk feeding, total milk feeding, necrotizing enterocolitis, average period of hospitalization and mortality. For statistical analysis, descriptive data are reported as mean ± standard deviation and median (range). The non parametric test of Mann-Whitney was used. The threshold for statistical significance was P < 0.05 (Two-Tailed).
RESULTS: Sixty-eight cases of GS were studied. We found nine cases of perforations, eight of volvulus, 12 of atresia and 49 children with subjective description of perivisceritis (72%). The mortality rate was 12% (eight deaths). Average duration of total parenteral nutrition was 56.7 d (8-950; median: 22), with five cases of necrotizing enterocolitis. Average length of hospitalization for 60 of our patients was 54.7 d (2-370; median: 25.5). The presence of intestinal atresia was the only factor correlated with prolonged parenteral nutrition, delayed total oral milk feeding and longer hospitalization.
CONCLUSION: In our study, intestinal atresia was our predictive factor of the severity of GS.
Core tip: Gastroschisis (GS) is defined as a full-thickness congenital abdominal wall defect usually situated on the right side of the umbilicus, with intestines protruding into the amniotic fluid without any protective membrane. The amniotic fluid creates an inflammation of the bowel wall, called perivisceritis. Associated with intestinal abnormalities are malrotation and a degree of short bowel: Volvulus, perforation and atresia may also be found. Our study shows that for babies born with GS, intestinal atresia is the only factor of prediction of the need for early and full enteral feeding, for its duration, and for the length of hospitalization.
