136 Short-term outcomes for preterm infants with surgical necrotizing enterocolitis

• Published in: Archives of disease in childhood Vol. 106; no. Suppl 2; p. A58
• Main Authors: Tomislav, Ćaleta, Iva, Vukšić, Petra, Živković, Vesna, Benjak, Andrea, Dasović Buljević, Dorotea, Ninković, Boris, Filipović-Grčić, Ivana, Sabolić, Miram, Pasini, Stanko, Ćavar, Anko, Antabak, Tomislav, Luetić, Jurica, Vuković, Ruža, Grizelj, Nada, Sindičić Dessardo
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health 11-10-2021; BMJ Publishing Group LTD
• Subjects: Abstracts; Enterocolitis; Gastrointestinal diseases; Infants; Intestine; Laparotomy; Lethality; Medical records; Necrosis; Necrotizing enterocolitis; Neonates; Newborn babies; Patients; Pediatrics; Peritoneum; Pregnancy; Premature babies; Premature Infants; Referral; Retinopathy; Risk factors; Sepsis; Short bowel syndrome; Surgical drains; Young Children
• DOI: 10.1136/archdischild-2021-europaediatrics.136
• EISSN: 1468-2044
• ISSN: 0003-9888

GoalThe purpose of this study was to characterize the population and evaluate risk factors, surgical treatments and short-term outcomes in preterm infants with surgical necrotizing enterocolitis (NEC).MethodsWe retrospectively evaluated premature infants with surgical NEC over a period of 5 years (2015-2019) in a Croatian tertiary referral centre. Data were extracted from medical records.ResultsThis study included 23 outborns aged 23 to 36 weeks of gestation (27.7±3.7). The median age at surgery was 11 days (5-43 days). Male gender (83%) was overrepresented, whereas antenatal steroid exposure was low (61%). The majority of patients (n=15) had a primary laparotomy (65%); two patients had peritoneal drainage (PD) alone (9%) and six patients had PD followed by laparotomy (26%). All patients survived. After referral, the median length of hospitalization was 128 days (15-430 days), one patient developed short bowel syndrome, five (22%) were treated for sepsis, eight patients (35%) received laser photocoagulation due to retinopathy, and grade 3 to 4 intraventricular hemorrhages were diagnosed in seven (30%) patients. There were no differences in outcomes related to surgical approach.ConclusionNEC mortality in our cohort is lower than current literature suggests. Additionally, abdominal drainage seems to be equally successful treatment of NEC as explorative laparatomy and bowel resection in neonates who do not meet the criteria for the latter procedures. Neonates who underwent abdominal drainage do not show increased probability of complications or higher lethality.