• Patrick M Chesley, Daniel J Ledbetter, John J Meehan, Assaf P Oron, and Patrick J Javid.
• Division of Pediatric General and Thoracic Surgery, University of Washington School of Medicine and Seattle Children's Hospital, Seattle, WA, USA; Department of General Surgery, Madigan Army Medical Center, Fort Lewis, WA, USA.
• Am. J. Surg. 2015 May 1; 209 (5): 901-5; discussion 905-6.

BackgroundGastroschisis is a newborn anomaly requiring emergent surgical intervention. We review our experience with gastroschisis to examine trends in contemporary surgical management.MethodsInfants who underwent initial surgical management of gastroschisis from 1996 to 2014 at a pediatric hospital were reviewed. Closure techniques included primary fascial repair using suture or sutureless umbilical closure, and staged repair using sutured or spring-loaded silo (SLS). Data were separated into 3 clinical eras: pre-SLS (1996 to 2004), SLS (2005 to 2008), and umbilical closure (2009 to 2014).ResultsIn the pre-SLS era, 60% (34/57) of infants with gastroschisis underwent primary repair. With the advent of SLS, there was a decrease in primary repair (15%, 10/68, P < .0001). Following introduction of sutureless umbilical closure, 61% (47/77) of infants have undergone primary repair. On multivariate regression, primary repair was associated with shorter intensive care unit stays (P < .001) and time to initiate enteral nutrition (P < .01).ConclusionsFollowing introduction of a less invasive technique for gastroschisis repair, most infants with gastroschisis were able to be repaired primarily. Primary repair should be considered in all babies with gastroschisis and favorable anatomy.Copyright © 2015 Elsevier Inc. All rights reserved.

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