Feasibility of open abdomen surgery treatment for near fatal necrotizing enterocolitis in preterm infants
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In brief
In brief
This retrospective study evaluates open abdomen surgery as an alternative treatment for severe necrotizing enterocolitis with intra-abdominal hypertension in preterm infants. Among 29 patients, 48% survived to discharge without short bowel syndrome, with surgery improving respiratory and hemodynamic parameters.
Written by the GCMD Library team from the article.
Introduction
Necrotizing Enterocolitis (NEC) remained a dramatic complication leading to death or neonatal morbidities in preterms. For some, Intra-Abdominal Hypertension (IAH) and Abdominal Compartment Syndrome worsened the multi-organ failure. An open abdomen surgery could be an alternative to conventional surgical treatment to move beyond this stage.
Objectives
To retrospectively describe the clinical course, pre- and post-operative features of preterms suffering from severe NEC with IAH treated by open abdomen surgery and referred to our center from October 2007 to September 2019. Our secondary objective is to identify various risk factors for mortality in this population.
Methods
Data on neonatal, clinical, biological, pre and post-operative features and outcome were collected. Univariate analyses were performed to compare their pre and post-operative features stratifying on outcome.
Results
Among 29 included patients, 14 (48%) survived to discharge without short bowel syndrome. Death was associated with an earlier postnatal age at NEC (16.3±9.1 versus 31.3±25.9 days; p=.004) and followed a withdrawal of treatment in 60% of cases. Surgery was associated with a significant improvement of respiratory and hemodynamic features (decrease of mean ventilator pressure from 13.1±5.4 to 11.3±4.0 cmH2O, p