Short-term postoperative complications in preterm neonates with surgical necrotizing enterocolitis: a multicenter retrospective cohort study
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In brief
In brief
This multicenter study of 326 preterm neonates who underwent surgery for necrotizing enterocolitis found a 57% postoperative complication rate within 30 days, with sepsis, stoma-related issues, and wound dehiscence being most common. Cardiovascular support prior to surgery increased risk of major complications, while stoma creation was associated with minor complications.
- 57% of preterm neonates with surgical NEC experience postoperative complications within 30 days, with 19% mortality rate.
- Most common complications are sepsis (19%), stoma-related issues (13%), and wound dehiscence (11%).
- Cardiovascular support between diagnosis and surgery doubles the risk of major postoperative complications (OR 1.92).
- Stoma creation increases risk of minor complications 6-fold compared to primary anastomosis (OR 6.73).
- These complication rates provide evidence-based data for preoperative parental counseling in surgical NEC cases.
Written by the GCMD Library team from the article.
Abstract
Background
Over half of preterm neonates with necrotizing enterocolitis (NEC) require surgery, making it essential to understand short-term postoperative outcomes and complication rates. Therefore, this study aimed to provide an overview of 30-day postoperative complications for NEC. Secondary, risk factors for minor and major short-term postoperative complications were identified.
Methods
This retrospective study included all preterm infants (GA < 35w) surgically treated for NEC from 2008 to 2022. Postoperative complications were scored following the Clavien–Madadi classification. Risk factors were analyzed using multivariable logistic regression analysis.
Results
In this cohort of 326 patients, 204 received a stoma, 80 had a primary anastomosis, and 32 had both. Postoperative mortality was 19.0%. In total, 186 patients experienced 238 complications (57.1%), including 118 (63.4%) major and 68 (36.6%) minor complications. Most common complications were sepsis (19.4%), stoma-related (13.3%), and wound dehiscence (11.3%). Cardiovascular support between NEC diagnosis and surgery was a significant risk factor for major complications (OR: 1.92, 95%-CI 1.19–3.08, p = 0.007) and stoma creation for minor complications (OR: 6.73, 95%-CI 2.05–22.05, p = 0.002).
Conclusion
This study showed a postoperative complication rate of 57.1%. We found cardiovascular support between NEC diagnosis and surgery as risk factor for major complications and stoma creation as risk factor for minor complications. These findings provide valuable insights for improving parental counseling on NEC outcomes.
Level of evidence
II