Introduction: Gastroschisis is one of the neonatal pathologies
with bad prognosis in developing countries due to a lack of equipment. We aim to report one way of
managing this malformation that could be practised everywhere, constituting an
alternative approach to surgery in poor areas. PatientsandMethods: This observational and descriptive study included newborn babies with
gastroschisis who underwent gradual bedside reduction at the Paediatric Surgery
Department of the Yaounde Central Hospital. Results: Our cohort was
constituted by 32 newborn babies with a mean age of 18.12 hours on admission.
The Lefort type 2 was the most frequent in 81.25% of cases. The mean time for
oral feeding after complete reduction was 17.4 days and the duration of
hospital stay was 24.91 days. Survival rates were at 40.63%, with a residual
hernia after healing in 38.46% of cases. Conclusion: Despite the high rate
of mortality, gradual reduction of gastroschisis at the bedside seems to be an
opportunity for resource constrained areas and can be an alternative solution
to surgery.
References
[1]
Kohl, M., Wiesel, A. and Schier, F. (2010) Familial Recurrence of Gastroschisis Literature Review and Data from the Population-Based Birth Registry “Mainz Model”. Journal of Pediatric Surgery, 45, 1907-1912.
https://doi.org/10.1016/j.jpedsurg.2010.05.003
[2]
Wright, N.J., Sekabira, J. and Ade-Ajayi, N. (2018) Care of Infants with Gastroschisis in Low-Resource Settings. Seminars in Pediatric Surgery, 27, 321-326.
https://doi.org/10.1053/j.sempedsurg.2018.08.004
[3]
Wesonga, A., Situma, M. and Lakhoo, K. (2020) Reducing Gastroschisis Mortality: A Quality Improvement Initiative at a Ugandan Pediatric Surgery Unit. World Journal of Surgery, 44, 1395-1399. https://doi.org/10.1007/s00268-020-05373-w
[4]
Lefort, J., Borde, J., Mitrofanoff, P. and Ensel, J. (1978) Laparoschisis: Analyse d’une série de 19 cas. Annales de chirurgie Infantile, 19, 77-82.
Bianchi, A., Dickson, A.P. and Alizai, N.K. (2002) Elective Delayed Midgut Reduction—No Anesthesia for Gastroschisis: Selection and Conversion Criteria. Journal of Pediatric Surgery, 37, 1334-1336. https://doi.org/10.1053/jpsu.2002.35003
[7]
Velomalala, I., Ralahy, F.M., Ravololoniaina, T., Rabenasolo, M., Hunald, F.A. and Andriamanarivo, M.L. (2010) Prise en charge de l’omphalocèle et du Laparoschisis au CHU-JRA Antanarivo. Archives de Pédiatrie, 17, 101.
https://doi.org/10.1016/S0929-693X(10)70605-9
[8]
Räsänen, L. and Lilja, H.E. (2022) Outcome and Management in Neonates with Gastroschisis in the Third Millennium—A Single-Centre Observational Study. European Journal of Pediatrics, 181, 2291-2298.
https://doi.org/10.1007/s00431-022-04416-9
[9]
Zaccaria, L., Subotic, U., Mazzone, L., et al. (2018) Ward reduction—Rewarding Action? Surgery Open Access, 1, Article 001.
[10]
Forgues, D., Arba, R., Kalfa, N., Guibal, M.P., Sabatier Laval, E., Allal, H. and Galifer, R.B. (2010) Intérêtd’une nutrition entérale précoce chez le nouveau né opéré d’un laparoschisis. Archives de Pédiatrie, 17, 20.
https://doi.org/10.1016/S0929-693X(10)70289-X
[11]
Raymond, S.L., Hawkins, R.B., St Peter, S.D., Downard, C.D., Qureshi, F.G., Renaud, E., et al. (2020) Predicting Morbidity and Mortality in Neonates Born with Gastroschisis. Journal of Surgical Research, 245, 217-224.
https://doi.org/10.1016/j.jss.2019.07.065
[12]
Kimble, R.M., Singh, S.J., Bourke, C. and Cass, D.T. (2001) Gastroschisis Reduction under Analgesia in the Neonatal Unit. Journal of Pediatric Surgery, 36, 1672-1674.
https://doi.org/10.1053/jpsu.2001.27957
[13]
Fullerton, B.S., Velazco, C.S., Sparks, E.A., Morrow, K.A., Edwards, E.M., Soll, R.F., et al. (2017) Contemporary Outcomes of Infants with Gastroschisis in North America: A Multicenter Cohort Study. The Journal of Pediatrics, 188, 192-197.
https://doi.org/10.1016/j.jpeds.2017.06.013
[14]
Rentea, R.M. and Gupta, V. (2022) Gastroschisis. In: StatPearls, StatPearls Publishing, Treasure Island.
[15]
Bergholz, R., Boettcher, M., Reinshagen, K. and Wenke, K. (2014) Complex Gastroschisis Is a Different Entity to Simple Gastroschisis Affecting Morbidity and Mortality—A Systematic Review and Meta-Analysis. Journal of Pediatric Surgery, 49, 1527-1532. https://doi.org/10.1016/j.jpedsurg.2014.08.001
[16]
Davis, J.R., Nsengiyumva, A., Igiraneza, D., Hong, P., Umutoni, R., Neal, D., et al. (2022) Predictors of Survival: A Retrospective Review of Gastroschisis and Intestinal Atresia in Rwanda. Journal of Surgical Research, 273, 138-146.
https://doi.org/10.1016/j.jss.2021.12.035
[17]
Aké, Y.L., Kouassi-Dria, S., Midekor-Gonebo, K., Bonny-Obro, R., Ouattara, J.-J. and Moh, E.N. (2017) Laparoschisis au CHU de Cocody: Situation actuelle et difficultés thérapeutiques. Revintscméd-RIMS, 19, 139-143.
[18]
Wright, N.J., Sekabira, J. and Ade-Ajayi, N. (2018) Care of Infants with Gastroschisis in Low-Ressource Settings. Seminar in Pediatric Surgery, 10, 30065-30069.
[19]
Taher, H., Khalil, H., Ahmed, S., Gad, M., Elezaby, B., Magdy, A. and Abdullateef, K.S. (2022) Umbilical Hernia Repair Post Umbilical Cord Graft Closure of Gastroschisis: A Cohort Study. International Journal of Surgery Case Reports, 95, Article ID: 107175. https://doi.org/10.1016/j.ijscr.2022.107175
[20]
Fraser, J.A., Deans, K.J., Fallat, M.E., Helmrath, M., Kabre, R., Leys, C.M., et al. (2022) Evaluating the Risk of Peri-Umbilical Hernia after Sutured or Sutureless Gastroschisis Closure. Journal of Pediatric Surgery, 57, 786-791.
https://doi.org/10.1016/j.jpedsurg.2022.03.019
[21]
Grant, N.H., Dorling, J. and Thornton, J.G. (2013) Accouchement prématuré électif en cas de gastroschisis fœtal. Cochrane Database of Systematic Reviews, No. 6, Article No. CD009394.
