Related Experiment Videos
Resection with primary anastomosis for necrotizing enterocolitis: a contrasting view
A Cooper1, A J Ross, J A O'Neill
1Department of Surgery, Babies' Hospital, Columbia-Presbyterian Medical Center, New York, NY 10032.
Journal of Pediatric Surgery
|January 1, 1988
Summary
Primary anastomosis for necrotizing enterocolitis in infants showed lower survival (48%) compared to resection with enterostomy (72%). This retrospective study suggests enterostomy may be safer for surgical necrotizing enterocolitis treatment.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastrointestinal Surgery
Background:
- Necrotizing enterocolitis (NEC) is a critical gastrointestinal emergency in neonates.
- Surgical management is often required for advanced NEC.
- Primary anastomosis is increasingly advocated for NEC resection.
Purpose of the Study:
- To evaluate the efficacy and outcomes of primary anastomosis versus resection with enterostomy in infants with surgical NEC.
- To compare survival rates between different surgical approaches for NEC.
Main Methods:
- Retrospective review of 173 infants with advanced NEC treated since 1974.
- Analysis of outcomes for patients undergoing resection with primary anastomosis versus resection with enterostomy.
- Exclusion of patients with late stricture repair.
Main Results:
- Overall survival for resected NEC was 65% (96/143).
- Survival was lower with primary anastomosis (48%, 13/27) compared to enterostomy (72%, 83/116).
- Excluding early years (1974-1976), survival improved to 77% overall, with 64% for primary anastomosis.
Conclusions:
- Resection with enterostomy demonstrated a higher survival rate than primary anastomosis in this cohort of infants with surgical NEC.
- The findings question the routine use of primary anastomosis for NEC, suggesting enterostomy may be a safer initial approach.
- Further investigation into optimal surgical strategies for NEC is warranted.