[Isolated intestinal perforation in neonates: treatment with ostomy or primary anastomosis?]

Necrotizing enterocolitis and isolated intestinal perforation (IIP) are two different entities that have been often analysed together in the literature. We present our series of IIP cases who received surgical treatment by laparotomy.

A retrospective cohort study was conducted with neonates diagnosed of IPP and operated on between 2002 and 2013. We divided the sample into two groups: group O (laparotomy and ostomy) and Group S (laparotomy and primary repair of the perforation). We compared the following variables: mortality, development of complications and number of days of total parenteral nutrition (TPN). Categorical variables were compared with the χ2 test. Time of TPN was analysed with Kaplan Meier curves and comparison between groups with the log-rank test.

Thirty-four patients underwent surgery. Fourteen patients were included in group O and 20 in group S. Four (28,6%) cases died in group O and six (30.0%) in group S: no statistically significant differences were found in mortality (χ2= 0.08; p= 0.9). Four (28,6%) patients in group O presented complications compared with 7 (35%) in group S: there were no statistically significant differences (χ2= 0.1; p= 0.7). The median number of days of TPN was 38 in group O and 34 in group S: no significant differences were found (χ2= 1.4; p = 0.2).

No significant differences were found in terms of mortality, surgical complications and TPN between patients with IIP treated with primary anastomosis and patients treated with an ostomy.