2006, Number 2
Rev Mex Cir Pediatr 2006; 13 (2)
Forced staged reduction versus gravity reduction in gastroschisis. A comparative study
Pérez-Lorenzana H, Licona-Islas C, Mora-Fol JR, Zaldívar-Cervera JA, Valerio-Vázquez JR
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Language: Spanish
References: 8
Page: 56-62
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ABSTRACT
Introduction: Gastroschisis is a defect of the anterior abdominal wall. The incidence in our hospital is about 25 cases per year. They are mainly managed with placement of a silo, staged reductions, and secondary closure. The objective of this study is to compare the traditional silo reductions versus gravity reductionsMaterial and Methods: From august 2004 to february 2005 we used gravity reduction. We evaluated days of reductions, mechanical ventilation (MV), total parenteral nutrition (TPN), total hospital stay, neonatal intensive care unit stay (NICU), and complications. We compared with a retrospective cohort of patients managed with staged reductions choosen randomized. (randomly choosen ) (choosen at random), using Student T test.
Results: We included 10 patients per group, requiring a mean time of 5.9 days for closure, 12 days of MV, 19 of TPN, 20 days of stay in NICU, 24 days of total hospital stay with gravity reductions, no deaths. The control group required 7.2 days for closure, 16.7 days of MV, 27.4 days of TPN, 28.4 days in NICU, 34 days of total hospital stay, and 2 deaths. The main complication was sepsis.
Discussion: Our results agree with the previously reported form other authors. There are significative differences between both techniques, being more efficient and safer the gravity reduction. We recommend it as the technique of choice in patients with gastroschisis, in whom primary closure is not possible.
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