LONG TERM OUTCOME AND QUALITY OF LIFE IN CHILDREN BORN WITH GASTROSCHISIS: PG5-18

Aim: The purpose of this study was to determine the long term outcome and quality of life (QOL) of children born with gastroschisis. Methods: We conducted a retrospective, monocentric study among the 38 children treated for gastroschisis in our center between 1985 and 2000. Two died early and 5 were lost for follow-up. The 31 remaining children were evaluated through outpatient visits (n = 17) or telephone interviews (n = 14). Three parameters were analysed: 1) general health and bowel function, 2) growth, 3) psycho-motor development and school integration. Furthermore, a validated and age adapted QOL questionnaire was sent to each patient. Results: There were 19 males and 12 females (mean age 9.5 years, range 4-17 years). All children but 3 (a girl with short bowel syndrome requiring parenteral support during 9 years, and 2 children with mental retardation), had normal general health and required no medical care. 25 children (80%) never complained of recurrent abdominal pain. 26 (84%) had a normal intestinal transit. Growth was reduced during the first 3 years of life, but catching up was reached between 3 and 6 years. 7 children (22.6%) presented a delay to acquire language, walk, sitting without support, or to acquire anal continence. 11 children (35.5%) experienced school retardation due to a delayed start or first classes repeat. 26 QOL questionnaire were returned by the patients (84%). The QOL score was not statistically different in children with gastroschisis compared to controls (67.9 ± 15.4 vs 67.9 ± 13, p > 0.05). Similar results were obtained with the teenagers (67.7 ± 11.3 vs 60 ± 13.3, p > 0.05). Low QOL was correlated to prematurity (p = 0.014), a Schuster procedure (p = 0.008), and a stay in intensive care unit for more than 10 days (p = 0.007) during the neonatal period. Conclusion: This study demonstrates that gastroschisis can be completely corrected in the neonatal period without any sequelae. Favorable outcome is quickly achieved, except in case of short bowel syndrome. Quality of life of survivors is not compromised. Accordingly, prenatal counselling can be optimistic.