Surgical mortality and morbidity in extremely low-birth-weight infants

Twenty extremely premature infants (birth weight, less than 1,100 g) underwent 49 surgical procedures for acquired conditions, including necrotizing enterocolitis, other forms of gastrointestinal perforation, gastroesophageal reflux, patent ductus arteriosus, and hydrocephalus. Few congenital anomalies requiring operation were encountered in this group. The overall survival rate was 58%. Using a computerized data base to compare surgical patients with a weight-matched group of nonsurgical patients, it was shown that survival was similar and that adverse prenatal and perinatal influences were equally distributed between both groups. Surgery per se did not adversely influence survival in extreme low-birth-weight infants, and surgical patients are not a preselected group of stronger infants.