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Surgery for necrotising enterocolitis: primary anastomosis or enterostomy?
F N Hofman1, N M A Bax, D C van der Zee
1Department of Pediatric Surgery, Wilhelmina Children's Hospital, University Medical Center, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
Pediatric Surgery International
|June 16, 2004
Summary
Primary anastomosis after bowel resection for necrotising enterocolitis (NEC) is superior to enterostomy. While outcomes were similar, primary anastomosis led to shorter hospital stays for neonates with NEC.
Area of Science:
- Neonatal surgery
- Gastrointestinal surgery
- Pediatric surgery
Background:
- Necrotising enterocolitis (NEC) management remains debated.
- Surgical options include bowel resection with primary anastomosis or enterostomy.
Purpose of the Study:
- To compare outcomes of primary anastomosis versus enterostomy in neonates undergoing bowel resection for NEC.
- To evaluate the impact of surgical approach on hospital stay and complications.
Main Methods:
- Retrospective study of 63 neonates with NEC undergoing bowel resection (1990-2001).
- Group A: 34 neonates with primary anastomosis.
- Group B: 29 neonates with enterostomy.
Main Results:
- No significant differences in mortality, complication rates, or weight gain.
- Group B (enterostomy) had a significantly longer primary hospital stay (80 vs. 58 days).
- Group B required a second hospital stay to restore gastrointestinal continuity.
Conclusions:
- Primary anastomosis is associated with a shorter overall hospital stay compared to enterostomy.
- Primary anastomosis may be a superior surgical approach for NEC management, reducing the need for reoperation.