Decentralized Surgery of Abdominal Wall Defects in Germany

Overview

Journal Pediatr Surg Int

Specialties General Surgery
Pediatrics

Date 2020 Mar 29

PMID 32219563

Citations 6

Authors

Andrea Schmedding

Boris Wittekind

Emilia Salzmann-Manrique

Rolf Schloesser

Udo Rolle

Affiliations

Soon will be listed here.

Abstract

Purpose: Neonatal surgery for abdominal wall defects is not performed in a centralized manner in Germany. The aim of this study was to investigate whether treatment for abdominal wall defects in Germany is equally effective compared to international results despite the decentralized care.

Methods: All newborn patients who were clients of the major statutory health insurance company in Germany between 2009 and 2013 and who had a diagnosis of gastroschisis or omphalocele were included. Mortality during the first year of life was analysed.

Results: The 316 patients with gastroschisis were classified as simple (82%) or complex (18%) cases. The main associated anomalies in the 197 patients with omphalocele were trisomy 18/21 (8%), cardiac anomalies (32%) and anomalies of the urinary tract (10%). Overall mortality was 4% for gastroschisis and 16% for omphalocele. Significant factors for non-survival were birth weight below 1500 g for both groups, complex gastroschisis, volvulus and anomalies of the blood supply to the intestine in gastroschisis, and female gender, trisomy 18/21 and lung hypoplasia in omphalocele.

Conclusions: Despite the fact that paediatric surgical care is organized in a decentralized manner in Germany, the mortality rates for gastroschisis and omphalocele are equal to those reported in international data.

Citing Articles

Current Challenges in the Treatment of the Omphalocele-Experience of a Tertiary Center from Romania.

Tarca E, Cojocaru E, Trandafir L, Luca A, Tiutiuca R, Butnariu L J Clin Med. 2022; 11(19).

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Outcome and management in neonates with gastroschisis in the third millennium-a single-centre observational study.

Rasanen L, Engstrand Lilja H Eur J Pediatr. 2022; 181(6):2291-2298.

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The Financial Burden of Surgery for Congenital Malformations-The Austrian Perspective.

Gasparella P, Singer G, Kienesberger B, Arneitz C, Fulop G, Castellani C Int J Environ Res Public Health. 2021; 18(21).

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Jejunoileal Atresia: A National Cohort Study.

Schmedding A, Hutter M, Gfroerer S, Rolle U Front Pediatr. 2021; 9:665022.

PMID: 34136442 PMC: 8200531. DOI: 10.3389/fped.2021.665022.

Epidemiology and One-Year Follow-Up of Neonates with CDH-Data from Health Insurance Claims in Germany.

Wittekindt B, Doberschuetz N, Schmedding A, Theilen T, Schloesser R, Gfroerer S Children (Basel). 2021; 8(2).

PMID: 33672568 PMC: 7924040. DOI: 10.3390/children8020160.

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