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Complications after surgical intervention for necrotizing enterocolitis: a multicenter review
J R Horwitz1, K P Lally, H W Cheu
1Department of Surgery, University of Texas Medical School, Houston 77030, USA.
Journal of Pediatric Surgery
|July 1, 1995
Summary
Necrotizing enterocolitis (NEC) surgery in premature infants is complex. While survival rates are 72%, complications like sepsis and strictures are common, especially in very low birth weight infants.
Area of Science:
- Neonatal surgery
- Pediatric gastroenterology
- Critical care medicine
Background:
- Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease primarily affecting premature infants.
- Surgical intervention is often required for advanced NEC, carrying significant risks.
Purpose of the Study:
- To analyze the surgical complications and outcomes in a large cohort of infants treated for NEC.
- To identify factors associated with increased mortality and morbidity in NEC surgical patients.
Main Methods:
- Multicenter retrospective analysis of 252 infants undergoing surgical therapy for NEC between 1980 and 1990.
- Data collected included gestational age, birth weight, age at operation, operative procedures, and postoperative complications.
- Statistical analysis was performed to determine survival rates and risk factors.
Main Results:
- The 30-day survival rate was 72% among 252 infants.
- Common indications for surgery included pneumoperitoneum (42%).
- Postoperative complications occurred in 47% of patients, with sepsis, intestinal strictures, and short gut each affecting 9%.
Conclusions:
- Surgical NEC management has a 72% survival rate, but significant postoperative morbidity persists.
- Very premature infants (gestational age < 27 weeks, birth weight < 1000 g) face higher mortality risks.
- While mortality increases with extreme prematurity, postoperative complication rates are similar across different birth weight groups.