{Reference Type}: Journal Article
{Title}: Managing giant omphalocele: A systematic review of surgical techniques and outcomes.
{Author}: Ghattaura H;Ross A;Aldeiri B;Mutanen A;Saxena A;
{Journal}: Acta Paediatr
{Volume}: 0
{Issue}: 0
{Year}: 2024 Jul 11
{Factor}: 4.056
{DOI}: 10.1111/apa.17346
{Abstract}: <B>OBJECTIVE: </B>We analysed closure techniques in the treatment of giant omphalocele. A challenging pathology where there lacks consensus.<BR><B>METHODS: </B>Cochrane, MEDLINE and EMBASE were searched between 1 January 1992 and 31 December 2022 using terms and variations: omphalocele, exomphalos, giant, closure and outcome. Papers were selected using Preferred Reporting Items for Systematic review and Meta-Analyses 2020 criteria. Data collected included demographics, timing and technique of surgical repair, morbidity and mortality.<BR><B>RESULTS: </B>We identified 342 papers; 34 met inclusion criteria with a total 356 neonates. Initial non-operative management was described in 26 papers (14 dressings, eight silo, four serial sac-ligation). Operative techniques by paper were as follows: Early closure: nine primary suture closure without patch, two primary closure with patch and four mixed methods. Delayed closure: five simple, four-component separation technique, four tissue expanders, one Botox/pneumoperitoneum and two with patch. Median number of procedures was two (1-6) in the early group versus three (1-4) in the delayed. The most favourable was early primary closure with biological patch. The most unfavourable was delayed closure with patch. Cumulative reported mortality remained high, mostly due to non-surgical causes.<BR><B>CONCLUSIONS: </B>Definitions of giant omphalocele in the literature were heterogeneous with a variety of management approaches described.