The development of neonatal care and evaluation of the first five years experience in surgery of cleft lip in the neonatal period


Authors: J. Vokurková 1,2;  L. Elstnerová 3;  O. Lukášová 2;  I. Hufová 1
Authors‘ workplace: Klinika popálenin a rekonstrukční chirurgie FN Brno, LF MU Brno přednosta prof. MUDr. P. Brychta, CSc. 1;  Klinika dětské chirurgie, ortopedie a traumatologie FN Brno, LF MU Brno přednosta prof. MUDr. P. Gál, Ph. D. 2;  Pediatrická klinika FN Brno, LF MU Brno přednosta prof. MUDr. Z. Doležel, CSc. 3
Published in: Čes-slov Pediat 2011; 66 (6): 356-362.
Category: Original Papers

Overview

The objective of the work was to evaluate the first five years of experiences in the neonatal lip surgery of facial cleft and postoperative course of therapy at our workplace.

Methods:
The patients were treated for cleft lip, cleft lip and/or palate unilateral or bilateral since February 2005 to February 2010 at Faculty Hospital Brno. The hospital records were evaluated retrospectively.

Results:
In the cohort a total of 132 patients were enrolled. The cleft lip and palate was the most frequent (56.1%), in the unilateral forms the left-side cleft was found in 63.3%. In the first week after birth, 62.9% of newborns underwent surgery, 30.3% were operated in the second week and the remaining 6.8% underwent surgery between day 15 and 28 of life. There was no mortality and no significant anesthesia complication occurred. The postoperative artificial lung ventilation, duration of oxygen application, duration of the stay at the Intensive Care Unit, total hospitalization and other parameters observed were significantly decreasing over the years (p=0.001). The observed parameters were shorter in surgery performed in the first week of life as compared with those performed in the following weeks. Surgical complications were encountered in three cases only (2.3%).

Conclusion:
The optimal period for neonatal reconstruction of the lip and nose was found to be two days after birth. The prerequisite of successful intervention is a highly specialized workplace with experience team and top technical equipment. The early neonatal surgery of the lip exerts positive influence of the somatic development of the child, positive psychosocial effect on the family and by way of feedback on the child.  

Key words:
neonatal lip surgery, cleft lip, total cleft lip palate, newborn


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Labels
Neonatology Paediatrics General practitioner for children and adolescents
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