Abstract

Gastroschisis, an entity that belongs to congenital abdominal wall defects, leads towards long-lasting exposure of eviscerated bowels to the irritating influence of the amniotic fluid and their possible blood supply compromise due to the constricting ring defect. Gastroschisis represents a real surgical emergency although its etiopathology remains a mystery. The sooner the operation is performed, the better the patients outcome. The ultimate goal is as follows: placement of eviscerated bowels into the abdominal cavity and full reconstruction of the abdominal paries which can be obtained either in a one-step operation or by a multi-staged procedure. The choice of option depends on the size of the herniated intestines. In the presented series of 28 neonates, the authors were able to perform primary closure in 10 cases (37%). In the remaining 18 neonates a multi-staged procedure was introduced with the use of prosthetic material: polyester mesh covered with polyurethane (Tegmentum). Its removal and full reconstruction of the abdominal paries was possible within an average of 9 days. The overall mortality rate in the presented group (28.6%) was higher in the earlier series and has decreased constantly, reaching 0 in the past two years.

Keywords: Gastroschisis, abdominal defects, surgical treatment