Surgical findings during exploratory laparotomy are closely related to mortality in premature infants with necrotising enterocolitis

Aim This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. Methods We included infants admitted within one day of birth to our tertiary neonatal department at Rigshospital...

Full description

Saved in:
Bibliographic Details
Published in:Acta Paediatrica 2017-03, Vol.106 (3), p.399-404
Main Authors: Hansen, ML, Juhl, SM, Fonnest, G, Greisen, G
Format: Article
Language:English
Subjects:
Boys
Denmark - epidemiology
Disease Progression
Enterocolitis, Necrotizing - mortality
Enterocolitis, Necrotizing - surgery
Female
Humans
Infant, Newborn
Infant, Premature
Laparotomy
Male
Mortality
Necrotising enterocolitis
Ostomy
Preterm infant
Reoperation
Retrospective Studies
Surgery
Tomography
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim This study investigated whether a correlation existed between surgical findings during the first laparotomy for necrotising enterocolitis (NEC) and death and, or, disease progression. Methods We included infants admitted within one day of birth to our tertiary neonatal department at Rigshospitalet, Denmark, from 2006 to 2015, who underwent a laparotomy for acute NEC. They were classified according to the locality and extent of intestinal necrosis by a paediatric surgeon, based on the surgical findings. We correlated the surgical findings with postoperative outcomes, namely death and, or, progression of NEC. Results The first laparotomy showed that 48 infants had NEC, including 21 who demonstrated postoperative progression. Of these, six died before undergoing another laparotomy and 14 of the 15 infants who underwent relaparotomy also died. There was a significant association between surgical findings and NEC‐related mortality (p = 0.03). The association between surgical findings and the progression of NEC was also significant (p < 0.0001). Conclusion Surgical findings during laparotomy for NEC were strongly correlated with mortality, which was close to 100% after relaparotomy. Considering the discouraging outcome, further studies should focus on alternative surgical approaches, such as proximal diverting jejunostomy and the clip and drop technique for the treatment of severe NEC.
ISSN:0803-5253
1651-2227
DOI:10.1111/apa.13693