Although the outcome of newborns with surgical congenital diseases(e.g.,diaphragmatic hernia;esophageal atresia;omphalocele;gastroschisis) has improved rapidly with recent advances in perinatal intensive care and surg...Although the outcome of newborns with surgical congenital diseases(e.g.,diaphragmatic hernia;esophageal atresia;omphalocele;gastroschisis) has improved rapidly with recent advances in perinatal intensive care and surgery,infant survivors often require intensive treatment after birth,have prolonged hospitalizations,and,after discharge,may have longterm sequelae including gastro-intestinal comorbidities,above all,gastroesophageal reflux(GER).This condition involves the involuntary retrograde passage of gastric contents into the esophagus,with or without regurgitation or vomiting.It is a well-recognized condition,typical of infants,with an incidence of 85%,which usually resolves after physiological maturation of the lower esophageal sphincter and lengthening of the intra-abdominal esophagus,in the first few months after birth.Although the exact cause of abnormal esophageal function in congenital defects is not clearly understood,it has been hypothesized that common(increased intra-abdominal pressure after closure of the abdominal defect) and/or specific(e.g.,motility disturbance of the upper gastrointestinal tract,damage of esophageal peristaltic pump) pathological mechanisms may play a role in the etiology of GER in patients with birth defects.Improvement of knowledge could positively impact the long-term prognosis of patients with surgical congenital diseases.The present manuscript provides a literature review focused on pathological and clinical characteristics of GER in patients who have undergone surgical treatment for congenital abdominal malformations.展开更多
Introduction: Gastroschisis is one of the neonatal pathologies with bad prognosis in developing countries due to a lack of equipment. We aim to report one way of managing this malformation that could be practised ever...Introduction: Gastroschisis is one of the neonatal pathologies with bad prognosis in developing countries due to a lack of equipment. We aim to report one way of managing this malformation that could be practised everywhere, constituting an alternative approach to surgery in poor areas. Patients and Methods: This observational and descriptive study included newborn babies with gastroschisis who underwent gradual bedside reduction at the Paediatric Surgery Department of the Yaounde Central Hospital. Results: Our cohort was constituted by 32 newborn babies with a mean age of 18.12 hours on admission. The Lefort type 2 was the most frequent in 81.25% of cases. The mean time for oral feeding after complete reduction was 17.4 days and the duration of hospital stay was 24.91 days. Survival rates were at 40.63%, with a residual hernia after healing in 38.46% of cases. Conclusion: Despite the high rate of mortality, gradual reduction of gastroschisis at the bedside seems to be an opportunity for resource constrained areas and can be an alternative solution to surgery.展开更多
文摘Although the outcome of newborns with surgical congenital diseases(e.g.,diaphragmatic hernia;esophageal atresia;omphalocele;gastroschisis) has improved rapidly with recent advances in perinatal intensive care and surgery,infant survivors often require intensive treatment after birth,have prolonged hospitalizations,and,after discharge,may have longterm sequelae including gastro-intestinal comorbidities,above all,gastroesophageal reflux(GER).This condition involves the involuntary retrograde passage of gastric contents into the esophagus,with or without regurgitation or vomiting.It is a well-recognized condition,typical of infants,with an incidence of 85%,which usually resolves after physiological maturation of the lower esophageal sphincter and lengthening of the intra-abdominal esophagus,in the first few months after birth.Although the exact cause of abnormal esophageal function in congenital defects is not clearly understood,it has been hypothesized that common(increased intra-abdominal pressure after closure of the abdominal defect) and/or specific(e.g.,motility disturbance of the upper gastrointestinal tract,damage of esophageal peristaltic pump) pathological mechanisms may play a role in the etiology of GER in patients with birth defects.Improvement of knowledge could positively impact the long-term prognosis of patients with surgical congenital diseases.The present manuscript provides a literature review focused on pathological and clinical characteristics of GER in patients who have undergone surgical treatment for congenital abdominal malformations.
文摘Introduction: Gastroschisis is one of the neonatal pathologies with bad prognosis in developing countries due to a lack of equipment. We aim to report one way of managing this malformation that could be practised everywhere, constituting an alternative approach to surgery in poor areas. Patients and Methods: This observational and descriptive study included newborn babies with gastroschisis who underwent gradual bedside reduction at the Paediatric Surgery Department of the Yaounde Central Hospital. Results: Our cohort was constituted by 32 newborn babies with a mean age of 18.12 hours on admission. The Lefort type 2 was the most frequent in 81.25% of cases. The mean time for oral feeding after complete reduction was 17.4 days and the duration of hospital stay was 24.91 days. Survival rates were at 40.63%, with a residual hernia after healing in 38.46% of cases. Conclusion: Despite the high rate of mortality, gradual reduction of gastroschisis at the bedside seems to be an opportunity for resource constrained areas and can be an alternative solution to surgery.
