Gastroshizis: Classification
DOI:
https://doi.org/10.15574/PS.2019.63.50Keywords:
gastroschisis, classification, treatmentAbstract
Gastroschisis (GS) remains one of the most severe highly-fatal developmental defects in newborns. There is a large number of anatomical and pathophysiological features of this defect that have not yet been classified. This fact necessitates the creation of a comprehensive anatomical and pathophysiological classification of GS.
Aim: based on the retrospective analysis of clinical material, with the study of the nature and frequency of anatomical and pathophysiological features of the defect and developmental abnormalities and diseases associated with it, to develop a comprehensive classification of GS.
Materials and methods. A retrospective analysis of medical records of 119 newborns with GS, who were treated in the department of surgical correction of congenital malformations in children in SI «Institute of Pediatrics, Obstetrics and Gynecology named after Academician O.M. Lukyanova of the National Academy of Medical Sciences of Ukraine» from 1987 to 2018 (n=89) and in Mykolaiv Regional Children's Hospital from 1987 to 2005 (n=30).
Results. Isolated GS was detected in 67.2% (n=80) of patients. Associated GS, associated with concomitant malformations or other intrauterine pathology, was diagnosed in 34.8% (n=39) of patients, and 10.1% (n=12) with multiple malformations. Complicated GS was diagnosed in 18.5% (n=22). «Open» (typical) GS was diagnosed in 98.3% (n=117) of babies, «closed» – in 1.7% (n=2). Intrauterine growth retardation was detected in 38.7% (n=46) of babies with GS, and viscero-abdominal disproportion – in 90.7% (n=108).
Conclusions. The proposed GS classification reveals main anatomical and pathophysiological features of the defect and associated with it developmental abnormalities and intrauterine diseases affecting its prognosis; it gives an opportunity to develop optimal tactics and strategy of surgical treatment of this pathology and improve the results of treatment.
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