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Related Experiment Videos

Damage control laparotomy for generalized necrotizing enterocolitis.

Behrouz Banieghbal1, Michael R Davies

  • 1Division of Paediatric Surgery, Chris Hani Baragwanath Hospital, Old Potchstroom Road, 2013 Soweto, Republic of South Africa. banieghbal@worldonline.co.za

World Journal of Surgery
|January 17, 2004
PubMed
Summary

Damage control laparotomy (DCL) offers improved survival for neonates with generalized necrotizing enterocolitis (G-NEC). This early surgical approach preserves bowel length and avoids stomas, increasing the chances of a positive outcome.

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Area of Science:

  • Neonatal surgery
  • Pediatric gastroenterology
  • Surgical critical care

Background:

  • Generalized necrotizing enterocolitis (G-NEC) in neonates has a high mortality rate.
  • Some G-NEC cases involve extensive bowel necrosis with viable segments.
  • Aggressive early surgical intervention may improve outcomes in selected G-NEC patients.

Purpose of the Study:

  • To evaluate the efficacy of damage control laparotomy (DCL) in neonates with G-NEC.
  • To assess the impact of DCL on survival and morbidity in this patient population.
  • To determine if DCL can preserve bowel length and avoid stoma complications.

Main Methods:

  • Prospective study of neonates with G-NEC undergoing DCL.
  • DCL involves initial resuscitation, laparotomy with resection of necrotic bowel, and staged re-look laparotomy.

Related Experiment Videos

  • Bowel ends were anastomosed or tied, with re-anastomosis performed 3-4 days later.

    • Main Results:

    • 27 out of 104 neonates with G-NEC were selected for DCL.
    • 19 neonates survived the follow-up period.
    • Early mortality was linked to sepsis (6 patients); late mortality to short bowel syndrome (2 patients).

    Conclusions:

    • Damage control laparotomy (DCL) is a viable strategy to improve survival in surgical G-NEC.
    • DCL preserves maximal viable bowel length and avoids complications associated with proximal stomas.
    • This approach offers a potential benefit for neonates with extensive G-NEC and viable bowel segments.