WOFAPS 2025 8th World Congress of Pediatric Surgery

RUBI MARTINEZ, Nadia MARTINEZ, JESUS MARTINEZ, Miguel Torres, Jorge Cantu, Joel Cazares

Regional Maternal and Child Hospital of Nuevo León

Purpose: Analyze the treatment and outcomes of patients with gastroschisis, evaluating different surgical techniques to improve survival and quality of life, given the lack of a universally accepted method.

Method: This is an observational, descriptive, and retrospective study including patients diagnosed with gastroschisis over a 12-year period, from July 2012 to May 2024.

Results: A total of 124 patients were analyzed (76 male, 48 female), with an average maternal age of 19 years, gestational age of 25-40 weeks, 60% premature, and birth weight between 680 and 3750 grams. There were 103 cases of simple gastroschisis and 21 complex, with 1 closed gastroschisis and 13 associated with intestinal atresia. Primary closure was performed in 53 cases, surgical silo in 23, and Alexis preformed silo in 48 (since 2019, only Alexis was used). Closure with Alexis averaged was 5 days and surgical silo 14 days. Mechanical ventilation was required: primary closure 6 days, surgical silo 11 days, Alexis 3 days. Initiation of feeding: surgical silo 23 days, primary closure 14 days, Alexis 7 days. Of the 48 with Alexis, 32 had sutureless and 16 suture closure; in the group without suture, ventilation time was reduced by 50% and feeding was delayed by 4 days in those with suture. Hospital stay: surgical silo 60 days, primary closure 37 and Alexis 35. There were 17 deaths (2 with Alexis and suture, 15 in other groups), mainly due to sepsis.

Conclusion: Overall survival rate was 86%, increasing to 92% with sutureless closure. There was a reduction in mechanical ventilation days, fasting, and hospital stay, although standardized guidelines for treatment and feeding are still needed.