[193 cases of gastroschisis and omphalocele--postoperative results]. / 193 Fälle von Gastroschisis und Omphalozele--Postoperative Ergebnisse.

Treatment was applied to 97 cases of omphalocele and 96 cases of gastroschisis at the Dortmund Department of Paediatric Surgery over the past 20 years. The survival rate was 122. Follow-up checks were recently applied to 56 of those former patients, after nearly ten years had elapsed from surgery. Thirty-eight of these patients were clinically examined, while questionnaires were completed for the rest. Primary closures had been performed on 50 per cent of the cases, while the defects in the other children were closed in two stages, using dura implantation or silastic pouches, or were conservatively treated. Accompanying malformations were recorded from 21 per cent of the gastroschisis cases and from 28 per cent of those with omphalocele. Overall mortality accounted for 37 per cent, with mortality in the wake of receptive operations being as high as 40 to 50 per cent, the latter rate not depending on the primary approach. One and the same risk was found to exist for conservative treatment (applicable only to closed omphalocele) and primary surgical closure, as may be seen from statistical evaluation. The highest rate of relaparotomy occurred in the wake of dura implantation and use of silastic pouches.

[Late results following surgical therapy of Hirschsprung disease]. / Spätergebnisse nach chirurgischer Therapie des Morbus Hirschsprung.

Re-assessment was made of 21 children roughly 14 years after operations for Hirschsprung's disease, using Rehbein's technique. Mortality accounted for ten per cent. Relaparotomy was necessary in 20 per cent of the cases. Anastomotic leakage was recorded from 8 per cent and small bowel obstruction due to adhesions from 7 per cent. Obstipation, diarrhoea, and fecal soiling were recorded from 5 per cent each. None of the children exhibited fecal or urinary incontinence. These results are compared with a statistical record on follow-up checks made between 8 and 27 years after surgery.