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Primary anastomosis for necrotising enterocolitis: a 12-year experience
D M Griffiths1, D A Forbes, P J Pemberton
1Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia.
Journal of Pediatric Surgery
|June 1, 1989
Summary
Primary anastomosis is a safer surgical approach for necrotising enterocolitis (NEC) in infants compared to resection and exteriorisation. This method shows improved survival rates and shorter recovery times for neonates requiring surgical intervention for NEC.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastroenterology
Background:
- Necrotising enterocolitis (NEC) is a serious condition in neonates requiring surgical management.
- Historically, resection and exteriorisation was the standard surgical approach for NEC.
Purpose of the Study:
- To compare the outcomes of resection and primary anastomosis versus resection and exteriorisation in infants with NEC.
- To evaluate the safety and efficacy of primary anastomosis for NEC management.
Main Methods:
- Retrospective review of 50 infants with NEC requiring surgery between 1975 and 1987.
- Comparison of outcomes between infants undergoing resection and primary anastomosis versus resection and exteriorisation.
- Analysis of pre-operative factors, surgical approach, and post-operative outcomes.
Main Results:
- Primary anastomosis group had a significantly higher long-term survival rate (76%) compared to resection and exteriorisation (39%).
- Infants undergoing primary anastomosis experienced shorter hospital stays, reduced need for total parenteral nutrition, and faster progression to full feeds.
- No increase in short- or long-term morbidity or mortality was observed with primary anastomosis.
Conclusions:
- Primary anastomosis is the preferred surgical procedure for infants with NEC when viable bowel ends are present.
- This approach offers improved survival and reduced recovery times for neonates with NEC requiring laparotomy.