Clinical Outcomes of Omphalocele: An Analysis of 124 Patients

Authors

  • Rangrong Sriworarak Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
  • Arada Suthiwongsing Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand. Abstract
  • Tongkao Ratanasuwan Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand
  • Rangsan Niramis Department of Surgery, Queen Sirikit National Institute of Child Health, Bangkok, Thailand

Keywords:

abdominal wall defect, congenital anomalies, omphalocele

Abstract

Background: Omphalocele is defined as an anterior midline defect of the abdominal wall through which
various viscerae herniated into an avascular sac. Currently, the mortality rate is not decreasing because of high
incidence of severe associated abnormalities.
Objectives: The aim of this study was to review long-term outcomes of patients with omphalocele in the
recent 10-year period.
Materials and Methods: Medical records of patients with omphalocele who were treated at the Queen
Sirikit National Institute of Child Health (QSNICH) during 1998-2007 were collected. Patient’s data including
demographics, modes and results of the treatment were collected and analyzed.
Results: One hundred and twenty-four babies were treated for omphalocele at the QSNICH during the
study period. An incidence of omphalocele among neonates born at the Rajavithi hospital was about 1:2,800 live
births. Sizes of the omphalocele defects ranged from 2 to 13 cm. in diameter (average 4.5 cm.). Musculoskeletal
and cardiovascular defects were the most common abnormalities in this study. Eight patients succumbed before
the definitive treatment. Twenty-two patients (17%) who had severe associated anomalies and suspected
incompatible with life were conservatively treated by topical antiseptic therapy. Only 2 of the 22 neonates (9%)
survived. Ninety-four patients were operated on and primary fascial closure was feasible in 61 cases (49%).
Forty-four of the 61 patients (72%) survived. The duration from closure to the first oral feeding ranged from
7 to 14 days. The remaining 33 neonates (27%) with omphalocele defect larger than 6 cm. in diameter were
managed by staged operations and only 21 patients (63.6%) survived. Of the total 124 patients, 67 cases
survived. The overall survival rate was 54%. Fifty-seven patients (41%) died because of severe associated
anomalies and related complications including sepsis, pneumonia and congestive heart failure.
Conclusions: The important factor which influences the mortality of omphalocele is severe associated
anomalies. The survival rate might be improved if these anomalies could be corrected.

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Published

2016-04-01

How to Cite

1.
Sriworarak R, Suthiwongsing A, Ratanasuwan T, Niramis R. Clinical Outcomes of Omphalocele: An Analysis of 124 Patients. Thai J Surg [Internet]. 2016 Apr. 1 [cited 2024 Mar. 29];31(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/225876

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