Alaa Obeida, Rawan El-Hussein, Hadeer Mohamed NasrEldin, Mohammad Allam, Khaled Bahaaeldin, Sherif Kaddah, Aly Shalaby
{"title":"评估转运时间和手术时间对腹股沟畸形（GS）患者存活率的风险因素；八年回顾。","authors":"Alaa Obeida, Rawan El-Hussein, Hadeer Mohamed NasrEldin, Mohammad Allam, Khaled Bahaaeldin, Sherif Kaddah, Aly Shalaby","doi":"10.1007/s00383-024-05872-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The management of Gastroschisis in LMICs continues to be a challenge and is associated with very poor outcomes in contrast with HICs where survival rates near 100%. The purpose of this work is to provide an overview of survival over the past 8 years in a high-flow tertiary centre in Africa. It also investigates the effect of transfer-time and time-to-surgery on outcome.</p><p><strong>Methods: </strong>Retrospective case note review of all GS admissions. The variables assessed were gender, gestational age, weight, type of GS, transfer time, time to surgery and type of surgery. The primary outcome was survival.</p><p><strong>Results: </strong>A total of 171 GS cases were identified: 148 simple, 23 complex. Seven died before surgery. The median age at surgical intervention was 8.5 h (range, 0-48). Closure options ranged from single-staged (primary fascial, skin, umbilical flap and sutureless closure) or a staged (silo) closure. Overall survival was 34.5%. Cases transferred under 8 h had a 46% survival. Surgery under 12 h of life had highest survival, 45%. Simple GS survived better than complex GS (40% vs 10%). Primary closure had a significantly better survival compared to staged closure (51% vs 18%).</p><p><strong>Conclusions: </strong>Transfer-time < 8 h plays a vital role in survival of GS cases. Surgical intervention within 12 h of birth showed a statistically significant improvement in outcome. Primary closure was associated with better survival rates.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"40 1","pages":"295"},"PeriodicalIF":1.5000,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543767/pdf/","citationCount":"0","resultStr":"{\"title\":\"Assessment of transfer-time and time-to-surgery as risk factors to survival in Gastroschisis (GS) in a LMIC; an eight-year review.\",\"authors\":\"Alaa Obeida, Rawan El-Hussein, Hadeer Mohamed NasrEldin, Mohammad Allam, Khaled Bahaaeldin, Sherif Kaddah, Aly Shalaby\",\"doi\":\"10.1007/s00383-024-05872-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The management of Gastroschisis in LMICs continues to be a challenge and is associated with very poor outcomes in contrast with HICs where survival rates near 100%. The purpose of this work is to provide an overview of survival over the past 8 years in a high-flow tertiary centre in Africa. It also investigates the effect of transfer-time and time-to-surgery on outcome.</p><p><strong>Methods: </strong>Retrospective case note review of all GS admissions. The variables assessed were gender, gestational age, weight, type of GS, transfer time, time to surgery and type of surgery. The primary outcome was survival.</p><p><strong>Results: </strong>A total of 171 GS cases were identified: 148 simple, 23 complex. Seven died before surgery. The median age at surgical intervention was 8.5 h (range, 0-48). Closure options ranged from single-staged (primary fascial, skin, umbilical flap and sutureless closure) or a staged (silo) closure. Overall survival was 34.5%. Cases transferred under 8 h had a 46% survival. Surgery under 12 h of life had highest survival, 45%. Simple GS survived better than complex GS (40% vs 10%). Primary closure had a significantly better survival compared to staged closure (51% vs 18%).</p><p><strong>Conclusions: </strong>Transfer-time < 8 h plays a vital role in survival of GS cases. Surgical intervention within 12 h of birth showed a statistically significant improvement in outcome. Primary closure was associated with better survival rates.</p><p><strong>Level of evidence: </strong>Level III.</p>\",\"PeriodicalId\":19832,\"journal\":{\"name\":\"Pediatric Surgery International\",\"volume\":\"40 1\",\"pages\":\"295\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-11-07\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543767/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Surgery International\",\"FirstCategoryId\":\"92\",\"ListUrlMain\":\"https://doi.org/10.1007/s00383-024-05872-0\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"92","ListUrlMain":"https://doi.org/10.1007/s00383-024-05872-0","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Assessment of transfer-time and time-to-surgery as risk factors to survival in Gastroschisis (GS) in a LMIC; an eight-year review.
Background: The management of Gastroschisis in LMICs continues to be a challenge and is associated with very poor outcomes in contrast with HICs where survival rates near 100%. The purpose of this work is to provide an overview of survival over the past 8 years in a high-flow tertiary centre in Africa. It also investigates the effect of transfer-time and time-to-surgery on outcome.
Methods: Retrospective case note review of all GS admissions. The variables assessed were gender, gestational age, weight, type of GS, transfer time, time to surgery and type of surgery. The primary outcome was survival.
Results: A total of 171 GS cases were identified: 148 simple, 23 complex. Seven died before surgery. The median age at surgical intervention was 8.5 h (range, 0-48). Closure options ranged from single-staged (primary fascial, skin, umbilical flap and sutureless closure) or a staged (silo) closure. Overall survival was 34.5%. Cases transferred under 8 h had a 46% survival. Surgery under 12 h of life had highest survival, 45%. Simple GS survived better than complex GS (40% vs 10%). Primary closure had a significantly better survival compared to staged closure (51% vs 18%).
Conclusions: Transfer-time < 8 h plays a vital role in survival of GS cases. Surgical intervention within 12 h of birth showed a statistically significant improvement in outcome. Primary closure was associated with better survival rates.
期刊介绍：
Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children.
The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include:
-Review articles-
Original articles-
Technical innovations-
Letters to the editor
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