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Surgery-associated complications in necrotizing enterocolitis: A multiinstitutional study.

W J Chwals1, M L Blakely, A Cheng

  • 1Section of Pediatric Surgery, The University of Chicago, 5841 S Maryland Ave, MC4062, Chicago, IL 60637, USA.

Journal of Pediatric Surgery
|October 31, 2001
PubMed
Summary
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Infants undergoing surgery for necrotizing enterocolitis (NEC) face high complication rates, particularly those born extremely premature. Parents should anticipate multiple operations and potential wound or stomal issues.

Area of Science:

  • Pediatric Surgery
  • Neonatal Care
  • Gastroenterology

Background:

  • Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
  • Surgical intervention is often required for NEC, carrying significant risks.

Purpose of the Study:

  • To evaluate the incidence of wound and stomal complications following surgical treatment for NEC in infants.
  • To compare complication rates based on gestational age.

Main Methods:

  • Prospective data collection from 51 infants with surgically treated NEC across four university hospitals.
  • Patients stratified into two groups: gestational age <28 weeks (Group I) and >=28 weeks (Group II).
  • Analysis of wound (infection, dehiscence) and stomal (prolapse, retraction, necrosis, stricture) complications.

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Main Results:

  • Group I infants (born <28 weeks) had a significantly higher combined stomal/wound complication rate (47%) compared to Group II (29%).
  • A majority of infants in both groups eventually required laparotomy, with no significant difference between groups.
  • Multiple operations were common, with 45% requiring one, 35% requiring two, and 20% requiring three or more.

Conclusions:

  • Infants with NEC, especially those born extremely prematurely, experience substantial wound and stomal complication rates.
  • The high incidence of complications and need for multiple surgeries underscore the vulnerability of this patient population.
  • Informed parental counseling regarding expected complications and the likelihood of multiple operations is crucial.