Umbilical hernia following gastroschisis closure: a common event?

Umbilical hernia following gastroschisis closure: a common event?

Purpose To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. Methods With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007–2013). Patient demographics, gastroschis...

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Published in:Pediatric surgery international Vol. 32; no. 8; pp. 811 - 814
Main Authors: Tullie, L. G. C., Bough, G. M., Shalaby, A., Kiely, E. M., Curry, J. I., Pierro, A., De Coppi, P., Cross, K. M. K.
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-08-2016
Springer Nature B.V
Subjects:
Female
Gastroschisis - surgery
Hemostasis, Surgical - instrumentation
Hernia, Umbilical - etiology
Humans
Infant, Newborn
Male
Medicine
Medicine & Public Health
Original Article
Pediatric Surgery
Pediatrics
Postoperative Complications
Retrospective Studies
Surgery
Suture Techniques
Sutures
Sutured closure
Gastroschisis
Umbilical hernia
Sutureless closure
Primary closure
Staged closure
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Summary:Purpose To assess incidence and natural history of umbilical hernia following sutured and sutureless gastroschisis closure. Methods With audit approval, we undertook a retrospective clinical record review of all gastroschisis closures in our institution (2007–2013). Patient demographics, gastroschisis closure method and umbilical hernia occurrence were recorded. Data, presented as median (range), underwent appropriate statistical analysis. Results Fifty-three patients were identified, gestation 36 weeks (31–38), birth weight 2.39 kg (1–3.52) and 23 (43 %) were male. Fourteen patients (26 %) underwent sutureless closure: 12 primary, 2 staged; and 39 (74 %) sutured closure: 19 primary, 20 staged. Sutured closure was interrupted sutures in 24 patients, 11 pursestring and 4 not specified. Fifty patients were followed-up over 53 months (10–101) and 22 (44 %) developed umbilical hernias. There was a significantly greater hernia incidence following sutureless closure ( p  = 0.0002). In sutured closure, pursestring technique had the highest hernia rate (64 %). Seven patients underwent operative hernia closure; three secondary to another procedure. Seven patients had their hernias resolve. One patient was lost to follow-up and seven remain under observation with no reported complications. Conclusions There is a significant umbilical hernia incidence following sutureless and pursestring sutured gastroschisis closure. This has not led to complications and the majority have not undergone repair.
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ISSN:0179-0358
1437-9813
DOI:10.1007/s00383-016-3906-1