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Surgical Closure of Equine Abdomen, Prevention, and Management of Incisional Complications
Published on: May 10, 2024
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Morbidity associated with laparotomy-confirmed spontaneous intestinal perforation: A prospective multicenter analysis
Katherine Culbreath1, Gregory Keefe1, Erika M Edwards2
1Department of Surgery and Center for Advanced Intestinal Rehabilitation, Boston Children's Hospital, Boston, MA, USA.
Journal of Pediatric Surgery
|March 15, 2022
Summary
Spontaneous intestinal perforation (SIP) and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants result in similar high morbidity. These findings provide crucial data for family counseling regarding infant outcomes.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a common gastrointestinal emergency in premature infants.
- Spontaneous intestinal perforation (SIP) is a distinct condition with less understood associated morbidities.
- Comparative data on the long-term morbidities of SIP versus NEC in very low birth weight (VLBW) infants are lacking.
Purpose of the Study:
- To compare the morbidities associated with spontaneous intestinal perforation (SIP) and necrotizing enterocolitis (NEC) in very low birth weight (VLBW) infants.
- To establish benchmark data for counseling families of VLBW infants diagnosed with SIP or NEC.
Main Methods:
- A prospective, multicenter cohort study analyzed data from 2015-2019.
- Laparotomy-confirmed diagnoses of SIP or NEC in VLBW infants were included.
- Multivariable regression assessed length of stay, growth morbidity, and supplemental oxygen requirements.
Main Results:
- Of 201,300 VLBW infants, 1523 had SIP and 2601 had NEC.
- Length of stay was similar for SIP (92 days) and NEC (88 days), both significantly longer than controls (68 days).
- Growth morbidity at discharge was high and similar in both groups (74.2% vs 75.3%), while NEC infants were less likely to require supplemental oxygen (24.4% vs 34.9% for SIP).
Conclusions:
- Very low birth weight infants with SIP and NEC experience similarly high rates of morbidity, despite lower mortality in SIP.
- These findings underscore the significant long-term health challenges for infants with either condition.
- The data provide essential benchmarks for informed family counseling and management strategies.
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