Comparison of long-term outcomes and nutritional status between primary and non-primary fascial closure in omphalocele.

چکیده اصلی

PURPOSE: Operative strategies for omphalocele vary, and long-term outcomes remain limited. We aimed to compare postoperative and long-term outcomes of omphalocele repair with primary versus non-primary fascial closure. METHODS: A retrospective study of omphalocele at 2 institutions between 2006 and 2021 was conducted. After excluding patients with genetic disorders and severe associated anomalies, 41 patients (15 primary fascial and 26 non-primary fascial closures) were reviewed. RESULTS: Although there were no significant differences in defect size or liver herniation, non-primary fascial closure was significantly associated with a concomitant non-cyanotic cardiac anomaly. Time to first enteral feeding and length of hospital stay were significantly longer in non-primary fascial closure. For long-term outcomes, non-primary fascial closure was associated with significantly higher rates of failure to thrive during infancy (76% vs. 40%) and toddlerhood (62.5% vs. 23.1%). However, there were no significant differences in ventral hernia, respiratory, or neurodevelopmental problems. CONCLUSION: Non-primary fascial closure is associated with higher rates of failure to thrive, underscoring need for long-term follow-up of nutritional status; however, the higher incidence of cardiac anomalies in this group may reflect a bias toward selecting this closure technique. When feasible and not complicated, primary fascial closure might be preferred option for omphalocele.

ترجمه فارسی چکیده

هدف این مطالعه مقایسه نتایج پس از عمل و بلندمدت ترمیم انسداد ناف با بستن اولیه و غیراولیه فاسیال بود. این مطالعه بازنگری از ۴۱ بیمار در دو موسسه بین سال‌های ۲۰۰۶ تا ۲۰۲۱ بود. بستن غیراولیه فاسیال با ناهنجاری‌های قلبی غیرسیانوتیک هم‌زمان مرتبط بود. زمان شروع تغذیه روده‌ای و مدت اقامت در بیمارستان در بستن غیراولیه فاسیال به طور معناداری بیشتر بود. در نتایج بلندمدت، بستن غیراولیه فاسیال با نرخ بالاتر شکست در رشد در دوران نوزادی (۷۶٪ در مقابل ۴۰٪) و دوران خردسالی (۶۲.۵٪ در مقابل ۲۳.۱٪) مرتبط بود. نرخ ورم شکمی، مشکلات تنفسی یا رشد عصبی تفاوت معناداری نداشت.

متن کامل اصلی