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 Ford, Donald B. Shaul

Research output: Contribution to journalArticle

8 Citations (Scopus)

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

Fingerprint

Tissue Preservation
Gastroschisis
Parenteral Nutrition
Nutritional Requirements
Intestines
Short Bowel Syndrome
Umbilicus
Blood Vessels

Keywords

  • Gastroschisis
  • Intestinal atresia
  • Short bowel syndrome
  • TPN

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Estrada, J. J., Petrosyan, M., Hunter, C. J., Lee, S. L., Anselmo, D. M., Grikscheit, T. C., ... 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

Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length. / Estrada, Joaquin J.; Petrosyan, Mikael; Hunter, Catherine J.; Lee, Steven L.; Anselmo, Dean M.; Grikscheit, Tracy C.; Stein, James E.; Wang, Kasper S.; Ford, Henri; Shaul, Donald B.

In: Journal of Pediatric Surgery, Vol. 43, No. 12, 01.12.2008, p. 2213-2215.

Research output: Contribution to journalArticle

Estrada, JJ, Petrosyan, M, Hunter, CJ, Lee, SL, Anselmo, DM, Grikscheit, TC, Stein, JE, Wang, KS, Ford, H & Shaul, DB 2008, 'Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length', Journal of Pediatric Surgery, vol. 43, no. 12, pp. 2213-2215. https://doi.org/10.1016/j.jpedsurg.2008.08.047
Estrada JJ, Petrosyan M, Hunter CJ, Lee SL, Anselmo DM, Grikscheit TC et al. Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length. Journal of Pediatric Surgery. 2008 Dec 1;43(12):2213-2215. https://doi.org/10.1016/j.jpedsurg.2008.08.047
Estrada, Joaquin J. ; Petrosyan, Mikael ; Hunter, Catherine J. ; Lee, Steven L. ; Anselmo, Dean M. ; Grikscheit, Tracy C. ; Stein, James E. ; Wang, Kasper S. ; Ford, Henri ; Shaul, Donald B. / Preservation of extracorporeal tissue in closing gastroschisis augments intestinal length. In: Journal of Pediatric Surgery. 2008 ; Vol. 43, No. 12. pp. 2213-2215.
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