Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique

Giant omphaloceles (GO) frequently present challenges to closure that are often influenced by patient factors, including degree of visceroabdominal disproportion, associated comorbidities (including pulmonary hypoplasia), and variation in surgeon preference for both technique and timing of abdominal...

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Main Authors:	Zach Z. Zhang, Candace Haddock, Cynthia Verchere, Jugpal S. Arneja, Erik D. Skarsgard
Format:	Article
Language:	English
Published:	Elsevier 2019-12-01
Series:	Journal of Pediatric Surgery Case Reports
Online Access:	http://www.sciencedirect.com/science/article/pii/S2213576619302015

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spelling	doaj-182ffc7c16da4d088114028aa0ce45f72020-11-25T01:08:42ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662019-12-0151Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation techniqueZach Z. Zhang0Candace Haddock1Cynthia Verchere2Jugpal S. Arneja3Erik D. Skarsgard4Division of Plastic and Reconstructive Surgery, Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Corresponding author. 2nd. Floor, Jim Pattison Pavilion North, 855 W. 12th. Avenue, Vancouver, British Columbia, V5Z 1M9, Canada.Division of Pediatric General Surgery, BC Children's Hospital and the University of British Columbia, Vancouver, BC, CanadaDivision of Pediatric Plastic Surgery, BC Children's Hospital, University of British Columbia, Vancouver, BC, CanadaDivision of Pediatric Plastic Surgery, BC Children's Hospital, University of British Columbia, Vancouver, BC, CanadaDivision of Pediatric General Surgery, BC Children's Hospital and the University of British Columbia, Vancouver, BC, Canada; Corresponding author. K0-110 ACB, 4480, Oak Street, Vancouver, British Columbia, V6H 3V4, Canada.Giant omphaloceles (GO) frequently present challenges to closure that are often influenced by patient factors, including degree of visceroabdominal disproportion, associated comorbidities (including pulmonary hypoplasia), and variation in surgeon preference for both technique and timing of abdominal wall reconstruction.In this case report, we describe our experience with a GO that presented the unique challenge of an uncharacteristically small fascial defect through which all structures (including liver) were herniated. The challenges of the small defect, both in potentially limiting the growth of healthy neoskin and preventing any degree of visceral reduction by compression are highlighted. An innovative reconstructive solution developed in collaboration with plastic surgery is described. Keywords: Giant omphalocele, Tissue expander, Amnion preservationhttp://www.sciencedirect.com/science/article/pii/S2213576619302015
collection	DOAJ
language	English
format	Article
sources	DOAJ
author	Zach Z. Zhang Candace Haddock Cynthia Verchere Jugpal S. Arneja Erik D. Skarsgard
spellingShingle	Zach Z. Zhang Candace Haddock Cynthia Verchere Jugpal S. Arneja Erik D. Skarsgard Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique Journal of Pediatric Surgery Case Reports
author_facet	Zach Z. Zhang Candace Haddock Cynthia Verchere Jugpal S. Arneja Erik D. Skarsgard
author_sort	Zach Z. Zhang
title	Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
title_short	Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
title_full	Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
title_fullStr	Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
title_full_unstemmed	Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
title_sort	management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique
publisher	Elsevier
series	Journal of Pediatric Surgery Case Reports
issn	2213-5766
publishDate	2019-12-01
description	Giant omphaloceles (GO) frequently present challenges to closure that are often influenced by patient factors, including degree of visceroabdominal disproportion, associated comorbidities (including pulmonary hypoplasia), and variation in surgeon preference for both technique and timing of abdominal wall reconstruction.In this case report, we describe our experience with a GO that presented the unique challenge of an uncharacteristically small fascial defect through which all structures (including liver) were herniated. The challenges of the small defect, both in potentially limiting the growth of healthy neoskin and preventing any degree of visceral reduction by compression are highlighted. An innovative reconstructive solution developed in collaboration with plastic surgery is described. Keywords: Giant omphalocele, Tissue expander, Amnion preservation
url	http://www.sciencedirect.com/science/article/pii/S2213576619302015
work_keys_str_mv	AT zachzzhang managementofnarrowstalkedgiantomphaloceleusingtissueexpansionstagedclosureandamnionpreservationtechnique AT candacehaddock managementofnarrowstalkedgiantomphaloceleusingtissueexpansionstagedclosureandamnionpreservationtechnique AT cynthiaverchere managementofnarrowstalkedgiantomphaloceleusingtissueexpansionstagedclosureandamnionpreservationtechnique AT jugpalsarneja managementofnarrowstalkedgiantomphaloceleusingtissueexpansionstagedclosureandamnionpreservationtechnique AT erikdskarsgard managementofnarrowstalkedgiantomphaloceleusingtissueexpansionstagedclosureandamnionpreservationtechnique
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Management of narrow stalked giant omphalocele using tissue expansion, staged closure, and amnion preservation technique

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