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A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town

Thesis (MScMedSc)--Stellenbosch University, 2017.

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Main Author: Van Eck, Andrew
Other Authors: Holgate, Sandi L.
Format: Thesis
Language:en_ZA
Published: Stellenbosch : Stellenbosch University 2017
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access_status_str Open Access
author Van Eck, Andrew
author2 Holgate, Sandi L.
author_browse Holgate, Sandi L.
Van Eck, Andrew
author_facet Holgate, Sandi L.
Van Eck, Andrew
author_sort Van Eck, Andrew
collection Thesis
dc_rights_str_mv Stellenbosch University
description Thesis (MScMedSc)--Stellenbosch University, 2017.
format Thesis
id oai:scholar.sun.ac.za:10019.1/102621
institution Stellenbosch University (South Africa)
language en_ZA
last_indexed 2026-06-10T12:41:04.390Z
license_str Other — see source repository
provenance_str_mv Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository
publishDate 2017
publishDateRange 2017
publishDateSort 2017
publisher Stellenbosch : Stellenbosch University
publisherStr Stellenbosch : Stellenbosch University
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source_str SUNScholar — Stellenbosch University Repository
spelling oai:scholar.sun.ac.za:10019.1/102621 A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town Van Eck, Andrew Holgate, Sandi L. Nel, Etienne D. L. R. Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Paediatrics and Child Health. Intestines -- Abnormalities Gastroschisis -- Prognosis Septicemia Newborn infants -- Diseases -- South Africa -- Cape Town UCTD Thesis (MScMedSc)--Stellenbosch University, 2017. ENGLISH ABSTRACT: Background The incidence of gastroschisis (GS) is rising and the outcomes in low to middle income countries are believed to be poor. Many studies from developed countries have evaluated prognostic factors and outcomes of GS, however there is little data from the developing world. Aim To determine the outcome of neonates treated for GS in a tertiary neonatal service in South Africa. Methods A retrospective case series of neonates admitted from January 2004 to July 2015 to the neonatal intensive care unit (NICU) at Tygerberg Children’s Hospital, Western Cape was conducted. Of the 39 cases, full clinical data was available for 31. All had surgery (primary closure or silo placement with delayed closure) and initial total parenteral nutrition (TPN). Main outcomes assessed were mortality rate, sepsis rate, time to full enteral feeding, occurrence of bowel related complications and the development of parenteral nutrition associated cholestasis (PNAC). Results Of the 31 neonates with GS, five (16%) cases were complex GS. Two (6.4%) neonates died. The culture proven sepsis rate was 46% and overwhelming infection was the most common cause of death. Seventy-one percent had no bowel related complications and the majority (67%) achieved full enteral feeding by 21 days. Six (24%) developed PNAC. Conclusion The outcome of GS in a single center tertiary hospital is comparable to that in high-income countries. The mortality and bowel complication rate is low, however there is a high rate of sepsis. To reduce mortality, strict infection prevention control is mandatory. AFRIKAANSE OPSOMMING: Agtergrond Die insidensie van gastroskese styg en die uitkomste in lae to middle inkomste lande is swak. Baie studies vanaf ontwikkelde lande het die prognostiese faktore en uitkomste van gastroskese ge-evalueer maar daar is min data op hierdie gebied. Doel Om die uitkomste van neonate met gastroskese te evalueer in n tersiere neonatale diens in Suid Afrika. Metodiek n Retrospektiewe gevalle studie van neonate toegelaat vanaf Januarie 2004 tot Julie 2015 tot die neonatale intensiewe eenheid by Tygerberg Kinder Hospitaal, Wes Kaap is onderneem. Nege-en-dertig gevalle is geindentifiseer waarvan 31 gevalle volledige kliniese rekords gehad het. Alle babas het chirurgie ondergaan (primere sluiting of ‘silo’ plasing met vertraagde sluiting) en binneaarse voeding. Hoofuitkomste beoordeel was sterftesyfer, infeksiekoers, tyd tot volle enterale voeding, voorkoms van derm verwante komplikasies en die ontwikkeling van binneaarse voedings verwante cholestase. Resultate Van 31 neonate met gastroskese, was daar 5 (16%) met gekompliseerde gastroskese. Twee neonate het gesterf. Die kultuur positiewe infeksie insidensie was 46% en oorweldigende infeksie was die mees algemeenste oorsaak van sterfte. Ee-en-sewentig present (71%) het geen derm verwante komplikasies ontwikkel nie en die meerderheid (67%) het volle enterale voedings teen 21 dae bereik. Ses (23%) het binneaarse voedings verwante cholestase ontwikkel. Gevolgtrekking Die uitkomste van gastroskese in n enkel tersiere hospitaal in Suid Afrika is vergelykbaar met die van hoe-inkomste lande. Die sterftesyfer en buik-verwante komplikasie syfer is laag, maar daar is n hoe infeksie insidensie. Om die sterftesyfer te verminder, is streng infeksiebekamping verpligtend. 2017-11-20T12:15:54Z 2017-12-11T10:33:13Z 2018-12-31T03:00:07Z 2017-12 Thesis http://hdl.handle.net/10019.1/102621 en_ZA Stellenbosch University 51 unnumbered pages application/pdf application/pdf Stellenbosch : Stellenbosch University
spellingShingle Intestines -- Abnormalities
Gastroschisis -- Prognosis
Septicemia
Newborn infants -- Diseases -- South Africa -- Cape Town
UCTD
Van Eck, Andrew
A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title_full A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title_fullStr A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title_full_unstemmed A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title_short A retrospective review of the outcomes of gastroschisis at a tertiary hospital in Cape Town
title_sort retrospective review of the outcomes of gastroschisis at a tertiary hospital in cape town
topic Intestines -- Abnormalities
Gastroschisis -- Prognosis
Septicemia
Newborn infants -- Diseases -- South Africa -- Cape Town
UCTD
url http://hdl.handle.net/10019.1/102621
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