AI Article Synopsis
- - The study aimed to analyze the causes, surgical approaches, and mortality rates of preterm neonates with necrotizing enterocolitis (NEC), a common surgical emergency.
- - Data from 109 neonates treated for NEC between 2017 and 2021 were examined, revealing significant preoperative findings, with a 37% overall mortality rate.
- - The predominant surgical treatment involved bowel resection, often accompanied by stoma formation, and the results align with previous studies despite the challenging conditions of very low gestational age in the patient population.
Article Abstract
Aim: Necrotising enterocolitis (NEC) is the dominating surgical emergency in preterm neonates. The aims were to investigate indications, surgical management and mortality for surgically treated neonates with NEC.
Methods: Data were retrieved from the Swedish Neonatal Quality Register for Swedish neonates with surgically treated NEC from 1 January 2017 to 31 December 2021. Diagnosis was validated by surgical records and histopathology. Neonates with isolated spontaneous intestinal perforation were excluded.
Results: In total, 109 neonates were included. Median gestational age was 25 weeks (22-38), and median birth weight was 771 g (269-3920). Preoperative pneumoperitoneum was found in 32%, portal venous gas in 25% and clinical deterioration on conservative treatment in 26% of the neonates. Among the 97 neonates presenting with small bowel necrosis, single-focal NEC occurred in 38 (39%), multifocal NEC in 35 (36%) and panintestinal NEC in 24 (25%). A primary anastomosis was performed in 10/87 (11%) of the neonates with bowel resection at primary surgery. Clip-and-drop technique was applied in 24/87 (28%).Mortality rate was 37%.
Conclusion: Mortality was well comparable with earlier reports considering exclusion of spontaneous intestinal perforation (SIP) and the low gestational age of the study population. Resection of necrotic bowel with stoma formation was the dominating surgical method.
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| http://dx.doi.org/10.1111/apa.16836 | DOI Listing |
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