Lyu Chengjie,Wang Peng,Ma Dong,et al.Childbirth cooperation integrated diagnosis and treatment of giant omphalocele[J].Journal of Clinical Pediatric Surgery,,():1133-1137.[doi:10.3760/cma.j.cn101785-202409081-005]
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Childbirth cooperation integrated diagnosis and treatment of giant omphalocele

Journal of Clinical Pediatric Surgery[ISSN:1671-6353/CN:43-1380/R] volume: Number: 2024 12 Page: 1133-1137 Column: 专题·出生缺陷的产前产后一体化诊治 Date of publication: 2024-12-01
Author(s):
Lyu Chengjie1;  Wang Peng1;  Ma Dong1;  Lai Dengming1;  Chen Zheng2;  Ying Liyang3;  Tan Zhen4;  Wang Liquan5;  Tou Jinfa1
1. Department of Neonatal Surgery,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;
2. Neonatal Intensive Care Unit,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;
3. Department of Cardiac Surgery,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;
4. Department of Thoracic Surgery,Affiliated Children’s Hospital,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China;
5. Department of Obstetrics,Center for Prenatal Diagnosis,Second Affiliated Hospital,Zhejiang University School of Medicine,Hangzhou 310003,China
Keywords:
Hernia; Umbilical; Interdisciplinary Communication; Pregnancy Outcome; Treatment Outcome; Disease Management
DOI:
10.3760/cma.j.cn101785-202409081-005
Abstract:
Objective To explore the application of childbirth cooperative management model of giant omphalocele (GO). Methods From January 2020 to December 2023,prenatal,prenatal and postpartum treatment data were retrospectively reviewed for 76 GO neonates.During a follow-up period of (9-36) month,healing of abdominal wall incision,feeding and growth were recorded. Results Prenatal ultrasonography offered a definite diagnosis and prenatal chromosome and genetic screening showed no abnormalities.As recommended by antepartum multi-disciplinary treatment (MDT),termination was performed for cloaca malformation (n=1),spinal malformation (n=1) and pedicle syndrome (n=1).And pregnancy was terminated due to complex heart malformation (n=2) and 71 cases continued pregnancy.In the whole group,capsule was wrapped in delivery room.There were capsule rupture (n=2,antenatal and labor each),hypoglycemia on admission (n=1) and hypothermia (n=1).The whole group included intestinal malrotation (n=68),Meckel’s diverticulum (n=2),atrial septal defects (n=6),ventricular septal defects (n=4),patent ductus arteriosus (n=8),esophageal atresia (n=2),diaphragmatic hernia (n=1),bronchopulmonary dysplasia (n=8) and pulmonary hypertension (n=10).The interventions included conservative measures (n=7),primary repair (n=35),second stage repair (n=27),staged repair (n=2) and combined surgery (n=3,diaphragmatic hernia,n=1; esophageal atresia,n=2).There were NEC (n=1),pneumonia atelectasis (n=5),incision infection (n=3) and intestinal obstruction (n=5) (hepatic caudate lobe compression during conservative period,n=1; intestinal adhesion during conservative treatment,n=1; adhesive intestinal obstruction post-operation,n=3).During treatment period,66 patients were discharged and 5 died in hospital (pulmonary hypertension,n=1; cardiac insufficiency,n=1; severe pneumonia,n=2; abdominal space syndrome,n=1).During follow-ups,death was due to accidental vomiting & asphyxia (n=1) and severe pneumonia from gastroesophageal reflux (n=1).Two cases of pulmonary hypertension were transferred to external hospital for treatment and the remainders recovered well. Conclusions The above integration mode may provide early interventions and effective managements of neonatal GO.

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Memo

收稿日期:2024-9-30。
基金项目:浙江省自然科学基金(LY22H040006)
通讯作者:钭金法,Email:toujinfa@zju.edu.cn

Last Update: 2024-12-28