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Eur J Pediatr Surg 2017; 27(06): 516-525
DOI: 10.1055/s-0037-1598250
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgical Management of Congenital Abdominal Wall Defects in Germany: A Population-Based Study and Comparison with Literature Reports

Carmen Dingemann
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
,
Janine Dietrich
2   Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
,
Jan Zeidler
2   Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
,
Jochen Blaser
3   Representative Office of Lower Saxony, Techniker Krankenkasse (Health Insurance), Hannover, Germany
,
Jan Hendrik Gosemann
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
4   Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
,
Martin Lacher
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
4   Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
,
Benno Ure
1   Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
› Author Affiliations
Further Information

Publication History

05 April 2016

22 December 2016

Publication Date:
24 February 2017 (online)

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Abstract

Introduction We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports.

Patients and Methods Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment.

Results Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p = 0.003) and hospitalization (p < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study.

Conclusion Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.

Keywords

omphalocele - gastroschisis - abdominal wall defect - neonatal - pediatric surgery

Funding

None.


 

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