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Necrotizing enterocolitis (NEC) surgery in infants showed a 72.5% overall survival rate. Surgical approach and timing did not impact survival, but complications like short-gut syndrome were noted in survivors.
Area of Science:
- Pediatric Surgery
- Neonatal Care
- Gastroenterology
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal emergency in neonates.
- Surgical intervention is often required for NEC, necessitating standardized treatment protocols.
Purpose of the Study:
- To evaluate the outcomes of a uniform surgical protocol for necrotizing enterocolitis in infants.
- To determine factors affecting survival and long-term sequelae in NEC patients.
Main Methods:
- A cohort of 51 infants with NEC underwent surgery between 1980 and 1983.
- The standard procedure involved segmental intestinal resection and exteriorization, with delayed intestinal continuity reestablishment.
- Indications for surgery included pneumoperitoneum or paracentesis suggesting bowel infarction.
Main Results:
- Overall survival rate was 72.5%, with 82% survival for those undergoing definitive surgical procedures.
- Patient weight, age, or presence of bowel perforation did not adversely affect survival rates.
- Postoperative complications were common, with short-gut syndrome affecting 11% of survivors.
Conclusions:
- The uniform surgical protocol yielded a significant survival rate for infants with necrotizing enterocolitis.
- Early surgical intervention and management strategies appear effective, irrespective of patient factors like weight or age.
- Long-term complications, particularly short-gut syndrome, require ongoing management in NEC survivors.
Abstract:
Fifty-one infants were treated surgically for necrotizing enterocolitis utilizing a uniform protocol from July 1980 through July 1983. The indications for surgery were pneumoperitoneum or a paracentesis indicative of bowel infarction. Segmental intestinal resection and exteriorization of the bowel ends through the upper abdominal transverse incision was the usual procedure. Intestinal continuity was reestablished when the patient reached 10 pounds, or sooner if he was failing to thrive with his ileostomy. The overall survival was 72.5%, and it was 82% for those patients have a definitive surgical procedure. This survival rate was not adversely affected by the patient's weight or age at the time of operation, nor by the presence of bowel perforation. The 37 survivors endured multiple postoperative complications. The most significant long-term sequela was short-gut syndrome, which occurred in 11% of survivors.