Past and Present in Omphalocele Treatment in Romania
E. Ţarcă, S.G. AproduOriginal article, no. 4, 2014
Background: Omphalocele is a congenital abnormalitywhose prognosis has improved significantly over the last fewdecades, reaching a survival rate of 80-90% in developedcountries. Currently, in Romania no comprehensive studyon the incidence, treatment, and survival of patients withthis defect of the anterior abdominal wall has been carriedout.Methods: This retrospective analytical study was conductedover a period of 23 years and included 105 children withomphalocele. Prenatal diagnosis, referral to our hospital,children age upon admission, associated diseases, medicaland surgical management, early and late postoperativecomplications, and the length of hospital stay were analysed.Results: The low rate of antenatal diagnosis (13.3%), thehigh frequency of associated congenital malformations (71.4%) and chromosomal abnormalities (27.6%), inadequateand delayed transport to a specialized pediatric surgerycenter together with an increased rate of sepsis (37.1%)resulted in a high mortality rate (54.3%).Conclusions: The significantly reduced length of hospital stayand higher survival rate despite the apparently morefrequent medical complications plead for the surgical treatment of omphalocele whenever not contraindicated by the presenceof severe pulmonary hypoplasia, cardiac defects, immaturityand other severe congenital anomalies, when conservativetreatment is indicated.
