[Gastroschisis and omphalocele. Treatment and results].

Between 1976 and 1988, 28 neonates with gastroschisis and 44 with omphalocele were treated. In 44 patients primary closure was achieved, while silastic prostheses were used in 23 patients, and dura implant in three patients. Two patients were not treated. The mortality rate was 8% (4/52) among the patients without serious congenital defects and birth weights over 1,800 g. This mortality was mainly caused by bowel infarction and, in infants with birth weights below 1,800 g, by the respiratory distress syndrome. Our experience suggests that ventilatory assistance with total paralysis is mandatory per- and postoperatively. The handling of these abdominal wall defects demands transport in an incubator with a nasogastric tube in place, a sterile bowel bag and replacement of fluid loss. Bowel stretch at the edge of the defect should be minimized in order to reduce the risk of bowel infarction. The favorable results of treatment of these malformations depend less on birth weight than on the presence of other serious congenital defects which are decisive for the mortality.