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:
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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