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Updated: Oct 28, 2026

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
What factors influence surgical decisions for post-NEC intestinal strictures in a 14-year, 325-case cohort?
Jinfeng Hou1, Qingshuang Liu1, Yi Wang1
1Department of General Surgery & Neonatal Surgery Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing Key Laboratory of Pediatrics, Chongqing, 401122, China.
Objective:
This study aimed to identify preoperative factors associated with stoma use in infants with post-NEC intestinal strictures and to develop a pragmatic model estimating the probability of staged stoma strategy selection.
Study Design:
A retrospective cohort of 325 infants who underwent surgery for NEC-related strictures at a single center (2010-2024) was analyzed. Preoperative variables were evaluated using LASSO logistic regression and multivariable modeling.
Results:
Four independent predictors associated with stoma use were identified: hematochezia, elevated CRP (> 8 mg/L), higher preoperative WBC, and lower weight at surgery. The model demonstrated good discrimination (AUC 0.814), with temporal validation AUC of 0.779.
Conclusions:
Preoperative inflammatory burden and lower weight at surgery were associated with stoma use in infants with post-NEC intestinal strictures. The model may support preoperative counseling and surgical planning, but should be interpreted as estimating the probability of stoma strategy selection in our institutional practice rather than defining objective indications for either stoma formation or primary anastomosis.
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