6572 Inside out! 10 year review of outcomes of neonates born with abdominal defects treated in a single tertiary centre

Objectives Gastroschisis and Exomphalos are the two most common congenital abdominal wall defects and occur in 1 in 4,000 live births. Our objective was to retrospectively assess the outcomes of infants with these abdominal defects treated in a single centre over 10 years. Methods This was a single-centre tertiary surgical neonatal unit. Medical records of a cohort of 110 infants admitted from 1st of January 2013 till 31st December 2022 with either gastroschisis or exomphalos were retrospectively reviewed to gather data on outcomes. Results Of the cohort of 110 neonates with abdominal wall defects, 75 (68%) had gastroschisis and 35 (32%) had exomphalos. The overall survival rate for infants with abdominal defects was 95% (105/110); with 97% (72/75) in Gastroschisis and 94% (33/35) in infants with exomphalos. 70% (52/75) of neonates with gastroschisis were preterm (<37 weeks) with 61% (46/75) weighing <2.5kg compared to 46% (16/35) preterm and 32% (11/35) <2.5kg in the infants with exomphalos. 97% (107/110) of infants with abdominal defects underwent surgical repair within 72 hours of birth. In the Gastroschisis cohort, 57% (43/75) had an uncomplicated primary repair, 19% (14/75) had a successful staged repair and 24% (18/75) had a complicated repair (complications from initial surgical intervention). In the exomphalos cohort, 63% (22/35) had a successful primary repair, 8.5% (3/35) had a successful staged repair, 20% (7/35) had a complicated repair and 3 cases of exomphalos were managed conservatively (no surgical intervention). The overall mortality of infants with abdominal wall defects was 4.5% (5/110). Infants born preterm <34 weeks, with birth weights <2500 g, were at the highest risk of death. The causes of death were bowel infarction, necrotising enterocolitis, compartment syndrome and multiple abnormalities. With regards to complications, the risk of compartment syndrome was doubled in infants with exomphalos; 8.5% (3/35) vs gastroschisis; 4% (3/75). 8% (6/75) of infants with gastroschisis vs 8.5% (3/35) of infants with exomphalos developed short gut syndrome and were discharged home with home parenteral nutrition. In the entire cohort,2/6 (30%) infants who had compartment syndrome developed short gut syndrome requiring home parenteral nutrition, whereas one case of compartment syndrome caused complications leading to death. Conclusion Our study has demonstrated there was a higher prevalence of infants with gastroschisis with a larger proportion of them being preterm and of low birth weight. Despite these, infants with abdominal wall defects demonstrate high survival rates.