Artículos de revistas
Surgical Treatment of Myelomeningocele Carried Out at `Time Zero` Immediately after Birth
Fecha
2009Registro en:
PEDIATRIC NEUROSURGERY, v.45, n.2, p.114-118, 2009
1016-2291
10.1159/000209285
Autor
PINTO, Fernando Campos Gomes
MATUSHITA, Hamilton
FURLAN, Andre Luiz Beer
ALHO, Eduardo Joaquim
GOLDENBERG, Dov Charles
BUNDUKI, Victor
KREBS, Vera Lucia Jornada
TEIXEIRA, Manoel Jacobsen
Institución
Resumen
Background/Aims: To present a protocol of immediate surgical repair of myelomeningocele (MMC) after birth (`time zero`) and compare this surgical outcome with the surgery performed after the newborn`s admission to the nursery before the operation. Methods: Data from the medical files of 31 patients with MMC that underwent surgery after birth and after admission at the nursery ( group I) were compared with a group of 23 patients with MMC admitted and prospectively followed, who underwent surgery immediately after birth - `at time zero` ( group II). Results: The preoperative rupture of the MMC occurred more frequently in group I (67 vs. 39%, p < 0.05). The need for ventriculoperitoneal shunt was 84% in group I and 65% in group II and 4 of them were performed during the same anesthetic time as the immediate MMC repair, with no statistically significant difference. Group I had a higher incidence of small dehiscences when compared to group II ( 29 vs. 13%, p < 0.05); however, there was no statistically significant difference regarding infections. After 1 year of follow-up, 61% of group I showed neurodevelopmental delay, whereas only 35% of group II showed it. Conclusions: The surgical intervention carried out immediately after the birth showed benefits regarding a lower incidence of preoperative rupture of the MMC, postoperative dehiscences and lower incidence of neurodevelopmental delay 1 year after birth. Copyright (C) 2009 S. Karger AG, Basel