Outcomes of surgical intervention for necrotizing enterocolitis within different pathological range
10.3760/cma.j.issn.2095-428X.2016.23.006
- VernacularTitle:不同病变范围新生儿坏死性小肠结肠炎手术干预效果分析
- Author:
Faling CHEN
;
Weijue XU
;
Longzhi LI
;
Xiong HUANG
;
Jun SUN
;
Yibo WU
;
Qingfeng SHENG
;
Zhibao LYU
- Keywords:
Necrotizing enterocolitis;
Extent of disease;
Laparotomy;
Ostomy;
Outcome
- From:
Chinese Journal of Applied Clinical Pediatrics
2016;31(23):1783-1786
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the surgical intervention outcomes of necrotizing enterocolitis (NEC)pa-tients with different extent of the disease.Methods The data of 25 pediatric patients with NEC who were treated with surgical intervention in Shanghai Children′s Hospital from December 201 1 to December 201 5 were retrospectively ana-lyzed.According to the extent of the disease,the patients were divided into 3 groups:focal disease(F),multisegmental disease(M),and pan -involvement(P).The information including operation style,survival rate and time for close osto-my was analyzed.Results There were 1 1 cases with F,8 cases with M,and 6 cases with P.All patients received lapa-rotomy surgery,colostomy,or peritoneal drainage.There were 1 2 patients with very low birth weight,7 patients with low birth weight,6 patients with normal birth weight in this study.There were 1 7 cases with gastrointestinal perforation (9 cases with pneumoperitoneum,8 cases without pneumoperitoneum),8 cases without digestive tract perforation (4 cases without pneumoperitoneum,4 cases with enterostenosis after conservative treatment).In this study,close ostomy was commonly conducted 3 -6 months after the operation,except for 3 cases who received 2 or more times of operation.The survival rate in F group was 1 00.0%(1 1 /1 1 cases),higher than those in the Mgroup with 62.5%(5 /8 cases)and P group with 1 6.7%(1 /6 cases)(χ2 =4.898,1 0.31 2,all P <0.05).However,there was no difference between Mgroup and P group (χ2 =1 .367,P >0.05).Conclusions The extent of disease is correlated to the outcomes of surgical in-tervention,as F had a better outcome than Mand P.Low birth weight is a risk factor for NEC.Protecting the edge of the bowel is a key factor to ensure the survival and improve the quality of life of NEC patients.Close ostomy should be con-sidered when the patients are in a stable condition (liver function and intestinal function recovery,good nutrition condi-tion,etc),and under special circumstances to conduct early or delayed closure of fistula.
