Abstract
Introduction Congenital microgastria is an extremely rare birth defect. The aim of this study
was to present an overview of existing literature on the treatment of microgastria.
Materials and Methods The term “microgastria” was used in a PubMed and Medline search. Since merely case
reports were found, only a narrative synthesis with limited statistical analysis can
be given. Data of different treatment modalities were collected and divided into two
groups: conservative or less invasive treatment (C/LT, i.e., modified diet or a gastrostomy/jejunostomy)
and extensive gastric surgery (EGS, i.e., Hunt–Lawrence pouch or total esophageal
gastric dissociation). Clinical outcome parameters (nutrition, growth pattern, and
mortality) were compared.
Results Out of 73 articles published from 1973 to 2019, 38 articles describing 51 cases were
included. In four patients, microgastria was an isolated anomaly (8%). Type of treatment
was described in only 46 patients, 19 were treated by C/LT. Mortality was 9/19 (47%)
in the C/LT group versus 4/27 (15%) in the EGS group (chi-square = 5.829, p = 0.016, Fisher = 0.022). There was a negative correlation between the invasiveness
of the treatment and both mortality (r = −0.356, p = 0.015) and comorbidity (r = −0.506, p <0.001). Patients in the C/LT group had significantly more comorbidity than in the
EGS group (mean = 4.32 vs. 2.26, p = 0.001). There was a positive correlation between comorbidity and mortality (r = 0.400, p = 0.006). Median follow-up was 42 months (range: 1–240). Type and way of nutrition
were poorly described. In at least 9 of the 33 surviving patients, oral feeding was
reported as normal, of whom 8 belonged to the EGS group. In all patients, growth could
be acknowledged, but in comparison to peers, final body length was less. There was
no difference in final body length between the two treatment groups.
Conclusion In patients with congenital microgastria, only minimal differences in clinical outcome
in terms of type of nutrition and body growth were found when C/LT was compared with
treatment by EGS. Mortality was significantly higher in the first group as well as
the amount of comorbidities.
Keywords
microgastria - congenital microgastria - Hunt–Lawrence pouch - total esophageal gastric
dissociation - intestinal malrotation
