Eur J Pediatr Surg 2017; 27(06): 516-525
DOI: 10.1055/s-0037-1598250
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Surgical Management of Congenital Abdominal Wall Defects in Germany: A Population-Based Study and Comparison with Literature Reports

Carmen Dingemann1, Janine Dietrich2, Jan Zeidler2, Jochen Blaser3, Jan Hendrik Gosemann1, 4, Martin Lacher1, 4, Benno Ure1
  • 1Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany
  • 2Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
  • 3Representative Office of Lower Saxony, Techniker Krankenkasse (Health Insurance), Hannover, Germany
  • 4Department of Pediatric Surgery, University of Leipzig, Leipzig, Germany
Further Information

Publication History

05 April 2016

22 December 2016

Publication Date:
24 February 2017 (eFirst)


Introduction We aimed to analyze for the first time the characteristics, treatment modalities, and outcomes in infants with congenital abdominal wall defects (CAWDs) in Germany and to compare the results with current literature reports.

Patients and Methods Data of a health insurance covering approximately 10% of the German population were analyzed. Patients who had undergone CAWD closure during a period of nearly 6 years were included. Surgical approach was categorized into primary versus secondary closure. Complications were defined as any reintervention within 1 year after initial treatment.

Results Patients with gastroschisis were treated in 24 centers, newborns with omphalocele in 34 centers. There was no mortality, and the type of surgical approach had no significant impact on the incidence of complications in both gastroschisis and omphalocele. Out of 39 patients with gastroschisis, 72% had undergone primary closure being associated with a shorter duration of ventilation (p = 0.003) and hospitalization (p < 0.001). Out of 54 patients with omphalocele, 54% had undergone secondary closure, whereas modality of management did not affect duration of ventilation and hospitalization. Although heterogeneous, data of the current literature were comparable to those of this study.

Conclusion Unbiased data demonstrate for the first time that the quality of the current surgical management of newborns with CAWD across Germany is excellent. There was no correlation of complications with the method of closure in gastroschisis and omphalocele.