A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles

Introduction In spite of the advances in prenatal and neonatal medicine, giant omphalocele (GO) has remained as a challenge for pediatric surgeons. Although different techniques have been introduced for treating GO, the ideal treatment would be a primary closure without compromising the respiratory...

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Autores principales:	Hamidreza Foroutan, Behdad Jenabali Jahromi, Naficeh Dastgheyb, Soltan Najafi
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2013
Materias:	omphalocele synthetic graft patch Medicine R
Acceso en línea:	https://doaj.org/article/51d478c393524921a1442067ffa288b9
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spelling	oai:doaj.org-article:51d478c393524921a1442067ffa288b92021-11-14T06:43:17ZA New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles2783-243010.17795/acr-11504https://doaj.org/article/51d478c393524921a1442067ffa288b92013-06-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_45438_32ec3ac74cc99ff93a9de01669e32707.pdfhttps://doaj.org/toc/2783-2430Introduction In spite of the advances in prenatal and neonatal medicine, giant omphalocele (GO) has remained as a challenge for pediatric surgeons. Although different techniques have been introduced for treating GO, the ideal treatment would be a primary closure without compromising the respiratory system or multiorgan failure. However, reaching this goal is challenging due to the high degree of visceroabdominal disproportion. This present study described the results of primary or secondary closure of five GO cases using the “bilateral mesh graft” technique. Case presentation Five consecutive GO patients were treated in our department. Two patients underwent a primary closure, while three other patients underwent a secondary closure using the “bilateral mesh graft” technique. When two mesh grafts were bilaterally fixed to the rectus abdominis muscles, the abdominal wall was reconstructed in the midline. All 5 patients were closely monitored for potential complications and a follow-up was also performed for each patient after they were discharged. Discussion The “bilateral mesh graft” technique was performed on the pediatric patients with a median age of 2.5 months (range 3 days to 6 months). The median diameter of the abdominal wall defect was 9 cm (range 7-10 cm). Moreover, the median was increased in bladder pressure after closure was 6.4 cm H2O (range 3-10 cm H2O). One of the patients who underwent secondary closure was diagnosed with a congenital heart condition and died postoperatively due to heart failure and respiratory insufficiency. The median hospital staying duration of the four surviving cases was 4.5 days with minimal complications. During the follow-up appointments, all four surviving patients exhibited normal weight gain and a soft abdomen with no infections or erosions detected at the site of surgery. The “bilateral mesh graft” technique yielded good clinical outcomes in both the primary and secondary closure cases. However, prior to surgery, particularly in the primary closure cases, the patients must be evaluated for respiratory function and additional congenital anomalies, such as heart conditions, in order to minimize potential complications. Nevertheless, further research is still needed in order to determine the long-term effects of the functional aspects on the abdominal wall muscles and viscera.Hamidreza ForoutanBehdad Jenabali JahromiNaficeh DastgheybSoltan NajafiShiraz University of Medical Sciencesarticleomphalocelesynthetic graftpatchMedicineRENIranian Journal of Colorectal Research, Vol 1, Iss 1, Pp 0-0 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	omphalocele synthetic graft patch Medicine R
spellingShingle	omphalocele synthetic graft patch Medicine R Hamidreza Foroutan Behdad Jenabali Jahromi Naficeh Dastgheyb Soltan Najafi A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
description	Introduction In spite of the advances in prenatal and neonatal medicine, giant omphalocele (GO) has remained as a challenge for pediatric surgeons. Although different techniques have been introduced for treating GO, the ideal treatment would be a primary closure without compromising the respiratory system or multiorgan failure. However, reaching this goal is challenging due to the high degree of visceroabdominal disproportion. This present study described the results of primary or secondary closure of five GO cases using the “bilateral mesh graft” technique. Case presentation Five consecutive GO patients were treated in our department. Two patients underwent a primary closure, while three other patients underwent a secondary closure using the “bilateral mesh graft” technique. When two mesh grafts were bilaterally fixed to the rectus abdominis muscles, the abdominal wall was reconstructed in the midline. All 5 patients were closely monitored for potential complications and a follow-up was also performed for each patient after they were discharged. Discussion The “bilateral mesh graft” technique was performed on the pediatric patients with a median age of 2.5 months (range 3 days to 6 months). The median diameter of the abdominal wall defect was 9 cm (range 7-10 cm). Moreover, the median was increased in bladder pressure after closure was 6.4 cm H2O (range 3-10 cm H2O). One of the patients who underwent secondary closure was diagnosed with a congenital heart condition and died postoperatively due to heart failure and respiratory insufficiency. The median hospital staying duration of the four surviving cases was 4.5 days with minimal complications. During the follow-up appointments, all four surviving patients exhibited normal weight gain and a soft abdomen with no infections or erosions detected at the site of surgery. The “bilateral mesh graft” technique yielded good clinical outcomes in both the primary and secondary closure cases. However, prior to surgery, particularly in the primary closure cases, the patients must be evaluated for respiratory function and additional congenital anomalies, such as heart conditions, in order to minimize potential complications. Nevertheless, further research is still needed in order to determine the long-term effects of the functional aspects on the abdominal wall muscles and viscera.
format	article
author	Hamidreza Foroutan Behdad Jenabali Jahromi Naficeh Dastgheyb Soltan Najafi
author_facet	Hamidreza Foroutan Behdad Jenabali Jahromi Naficeh Dastgheyb Soltan Najafi
author_sort	Hamidreza Foroutan
title	A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
title_short	A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
title_full	A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
title_fullStr	A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
title_full_unstemmed	A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles
title_sort	new method of repairing giant omphaloceles with bilateral mesh grafts lateral to the rectus abdominis muscles
publisher	Shiraz University of Medical Sciences
publishDate	2013
url	https://doaj.org/article/51d478c393524921a1442067ffa288b9
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A New Method of Repairing Giant Omphaloceles with Bilateral Mesh Grafts Lateral to the Rectus Abdominis Muscles

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