Primary Closure Versus Staged Silo Closure in Neonatal Gastroschisis: A Narrative Review

Background: Gastroschisis is a congenital abdominal wall defect requiring urgent neonatal surgery.  Objectives: This study reviews recent evidence comparing primary closure and staged silo closure for gastroschisis, focusing on outcomes and applicability in high- and low-resource settings.  Methods: This is a review study. We searched electronic databases, including PubMed, Scopus, ScienceDirect, Google Scholar, SpringerLink, Elsevier, and ProQuest, using MeSH terms and Boolean operators to identify relevant studies published in English between January ۲۰۱۰ and July ۲۰۲۵. After applying the inclusion and exclusion criteria, ۹ studies were finally selected for review.    Results: The reviewed studies had been conducted in Australia, the UK, Poland, Indonesia, Ethiopia, and Colombia. They showed that early closure, particularly within five days of birth, significantly improved outcomes, including reduced need for ventilator use, earlier enteral feeding, and shorter hospital stays. In high-income countries, prenatal diagnosis, neonatal intensive care, and multidisciplinary surgical services supported favorable results. In contrast, low- and middle-income countries faced delayed referrals, limited surgical capacity, and higher mortality. Resource-based strategies, such as ileostomy-assisted closure and prenatal education campaigns, have emerged to address these challenges.  Conclusions: The findings suggest that health system readiness and timing of closure are more important than the type of surgical closure. Telemedicine, regional surgical centers, and standard protocols may help reduce global disparities in gastroschisis care. Timely, context-sensitive management remains essential for improving neonatal survival. The findings underscore the importance of equitable access to timely neonatal surgical care worldwide through coordinated policy and workforce development initiatives.

کلیدواژه ها:

Gastroschisis ، Primary Closure ، Staged closure