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PS-289 Does Local Experience In The Management Of Simple Gastroschisis (sg) Matter? (local Practice Versus National Benchmark Data)
  1. B Reulecke1,
  2. P Amess1,
  3. C Garland1,
  4. R Hallows2,
  5. A Butt3,
  6. H Rabe1,
  7. JR Fernandez Alvarez1
  1. 1Neonatology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  2. 2Paediatric and Neonatal Surgery, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK
  3. 3Paediatric Gastroenterology, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK


Background The most commonly performed procedures for SG are operative primary fascial-closure (OPC) and application of a preformed silo with delayed fascial-closure (PS). There is no consensus on optimal management.

Aim To compare our outcomes of SG-newborns after OPC with outcomes from a national cohort (British Association of Paediatric Surgeons-Congenital-Anomalies-Surveillance-System, BAPS-CASS) after OPC or PS.

Methods Retrospective comparison of SG-infants from a tertiary centre (2006–2013) with SG-newborns from BAPS-CASS. We compared baseline characteristics and outcomes: Antenatal diagnosis (AD), in-utero-transfer (IUTR), vaginal delivery (VD), gestational age ≥37 weeks (GA), birthweight ≥ 2500 g (BW), male gender (MALE), associated anomalies (AA); type/success of surgery, re-operation (RE-OP), abdominal compartment (AC), wound infection (WI), mechanical-ventilation (MV), parenteral nutrition <28 days (TPN), intestinal failure associated liver disease (IFALD), length of stay <30 days (LOS) and mortality. Data-presentation: Percentage (%). Data-analysis: Fisher’s-Exact-Test (p < 0.05).

Results 25 SG-newborns were compared with 336 newborns from BAPS-CASS. Baseline-characteristics were not significantly different (GA 60% vs 57% [p = 0.78], BW 56% vs 43% [p = 0.21]), rest not displayed). Significantly more OPC were intended and successfully completed locally than nationally (96% vs 42% [p < 0.0001]; 100% vs 82% [p = 0.03]). Outcomes were:

Abstract PS-289 Table 1

Compared to national PS TPN and LOS were significantly shorter after OPC locally (80% vs 48%[p = 0.004]; 68% vs 28%[p < 0.0001]); rest of outcomes not significantly different.

Conclusions Longstanding local experience with OPC positively affects outcomes in SG-infants exceeding some national outcomes irrespective of surgical method.

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