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Umbilical hernia following gastroschisis closure: a common event?

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Abstract

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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Authors and Affiliations

  1. Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, UK

    L. G. C. Tullie, G. M. Bough, A. Shalaby, E. M. Kiely, J. I. Curry, A. Pierro, P. De Coppi & K. M. K. Cross

  2. Division of General Surgery, Hospital for Sick Children, 555 University Avenue, Toronto, Canada

    A. Pierro

  3. Stem Cells and Regenerative Medicine Section, DBC, Institute of Child Health, University College London, London, WC1N 1EH, UK

    P. De Coppi

Authors
  1. L. G. C. Tullie
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  2. G. M. Bough
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  3. A. Shalaby
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  4. E. M. Kiely
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  5. J. I. Curry
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  6. A. Pierro
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  7. P. De Coppi
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  8. K. M. K. Cross
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Corresponding author

Correspondence to K. M. K. Cross.

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Tullie, L.G.C., Bough, G.M., Shalaby, A. et al. Umbilical hernia following gastroschisis closure: a common event?. Pediatr Surg Int 32, 811–814 (2016). https://doi.org/10.1007/s00383-016-3906-1

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  • DOI: https://doi.org/10.1007/s00383-016-3906-1

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