Intestinal stenting in preterm, very-low-birth-weight infants with necrotizing enterocolitis and multiple...

Area of Science:

• Neonatal surgery
• Pediatric gastroenterology
• Surgical innovation

Background:

• Necrotizing enterocolitis (NEC) poses a significant threat to preterm, very-low-birth-weight infants, often leading to intestinal perforations or necrosis.
• Standard surgical interventions for NEC with extensive bowel involvement may result in short bowel syndrome due to extensive resections or multiple anastomoses.

Observation:

• This study presents two cases of NEC in extremely preterm infants requiring surgical intervention for multiple intestinal perforations and segmental bowel necrosis.
• SILASTIC intestinal stents were employed as a novel surgical technique to bridge compromised bowel segments, aiming to preserve intestinal length.

Findings:

• The SILASTIC stent technique facilitated the management of complex NEC cases, avoiding the need for extensive bowel resections, formal anastomoses, or stomas.
• Both infants treated with SILASTIC stents were successfully discharged, avoided short bowel syndrome, and are currently thriving with minimal developmental delays.

Implications:

• The SILASTIC stent technique offers a valuable alternative for selected preterm infants with NEC, maximizing intestinal length preservation.
• This approach can potentially reduce operative time and mitigate the long-term complications associated with short bowel syndrome in this vulnerable population.
• Further research into this technique could refine surgical strategies for managing NEC in neonates.