A. Clausner et al., TREATMENT OF CONGENITAL ABDOMINAL-WALL DEFECTS - A 25-YEAR REVIEW OF 132 PATIENTS, Pediatric surgery international, 11(2-3), 1996, pp. 76-81
The outcome data of 132 patients treated at the Department of Pediatri
c Surgery in Mainz during the last 25 years were reviewed. Prenatal di
agnosis of abdominal wall defects (AWDs) and associated malformations
led to increasing selection of the patient population. The aim of prim
ary closure of the abdominal wall can be achieved more frequently in g
astroschisis (GS) than omphalocele (OC), while the postoperative cours
e is more complicated and of longer duration in GS. Delayed or seconda
ry closure extended the hospitalization period but had no negative eff
ects on the outcome. Reoperations or planned secondary operations were
performed in 23 patients with GS and 14 with OC. Early mortality was
15/55 for OC and 21/77 for GS over the period of 25 years. In recent y
ears, a drastic reduction in mortality has occurred, and mortality is
now mainly due to additional malformations. Further development and qu
ality of life are not significantly reduced after survival of an isola
ted AWD. Malpositioning of parenchymatous organs after closure of AWDs
has to be considered during pregnancy and abdominal operations.