266 Chapter 12 Even when patients with a gastroschisis are excluded from the analysis, our results show that primary anastomosis does not increase the chances of postoperative complications, most importantly anastomotic leakage and mortality. Moreover, primary anastomosis reduces the number of surgical procedures, reduces the total duration of hospital stay and, of course, do not result in enterostomy complications. Although many factors might imply the necessity of an enterostomy, like bowel perforation, meconium peritonitis or clinical status of the patient, enterostomy could also be considered the ‘safe’ option for the treating paediatric surgeon. Taking into account the higher complication risk found in patients treated with a temporary double barred enterostomy, however, one might consider performing primary anastomosis with a lower threshold.
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