Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length

Joaquin J. Estrada, Mikael Petrosyan, Catherine J. Hunter, Steven L. Lee, Dean M. Anselmo, Tracy C. Grikscheit, James E. Stein, Kasper S. Wang, Henri R. Ford, Donald B. Shaul

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background: Prenatal closure of the umbilical ring in gastroschisis may result in an amorphous, nonviable appearing extracorporeal tissue that is resected during the repair. However, it is unclear whether such remnant intestine is truly nonviable. Methods and Results: We examined the outcomes of patients when this tissue is preserved. We identified 8 patients who presented with a closing gastroschisis and a mass of tissue connected by a vascular pedicle. Four patients underwent abdominal exploration with resection of the mass and gastroschisis closure. Histologic examination revealed normal intestinal wall architecture. All patients in this group developed short bowel syndrome, requiring long-term parenteral nutrition. Conversely, 4 patients underwent abdominal exploration with internalization of the remnant tissue, a maneuver referred to as "parking," along with either silo placement, or primary closure of the gastroschisis. At re-exploration, 3 of 4 patients were found to have viable intestine, and bowel continuity was reestablished. The mean parenteral nutrition requirement for this group was significantly shorter than the resected group. Conclusion: In this series, we show that this amorphous tissue, when preserved, may exhibit normal intestinal architecture and absorptive function. Therefore, such remnant tissue should be preserved as it may significantly increase bowel length and minimize parenteral nutrition requirement.

Original languageEnglish (US)
Pages (from-to)2213-2215
Number of pages3
JournalJournal of Pediatric Surgery
Volume43
Issue number12
DOIs
StatePublished - Dec 1 2008
Externally publishedYes

Keywords

  • Gastroschisis
  • Intestinal atresia
  • Short bowel syndrome
  • TPN

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Fingerprint Dive into the research topics of 'Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length'. Together they form a unique fingerprint.

  • Cite this

    Estrada, J. J., Petrosyan, M., Hunter, C. J., Lee, S. L., Anselmo, D. M., Grikscheit, T. C., Stein, J. E., Wang, K. S., Ford, H. R., & Shaul, D. B. (2008). Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length. Journal of Pediatric Surgery, 43(12), 2213-2215. https://doi.org/10.1016/j.jpedsurg.2008.08.047