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Morbidity after surgical treatment of isolated intestinal perforation and necrotizing enterocolitis is similar in preterm infants weighing less than 1500 g.
J Pediatr Surg. 2010 Feb; 45(2):319-22; discussion 323.JP

Abstract

INTRODUCTION

Isolated intestinal perforation (IIP) and necrotizing enterocolitis (NEC) seem to be separate diseases, though their surgical treatment is similar. We compared the morbidity after surgery for IIP and NEC in preterm infants (birth weight <1500 g).

PATIENTS AND METHODS

Isolated intestinal perforation was defined as intestinal perforation with associated necrosis less than 5% of bowel length and NEC as necrosis of 5% or more of bowel length +/- perforation. Outcome measures included time to full enteral feeds, incidence of total parenteral nutrition-associated cholestasis, and nutritional and neurologic status up to 60 months of age. Data are quoted as median (range).

MAIN RESULTS

Sixty-one surviving patients treated between 1986 and 2006 were retrospectively reviewed (IIP: n = 32 versus NEC: n = 29). Median % resection of small and large bowel in IIP and NEC was 2% (1%-22%) versus 12% (6%-32%), and 5% (2%-13%) versus 7% (2%-25%), respectively (P < .05 in both). There was no significant difference in gestational age, birth weight, incidence of cerebral hemorrhage, respiratory distress syndrome, or surgical technique (enterostomy or primary anastomosis). Median time to enteral feeds, incidence of total parenteral nutrition-associated cholestasis, length of ventilation, and ultimate nutritional and neurologic outcome did not differ statistically significantly between the groups.

CONCLUSION

Surgery in NEC resulted in more extensive intestinal resection than in IIP. However, subsequent morbidity was similar in both groups.

Authors+Show Affiliations

Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland. antti.koivusalo@hus.fiNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20152344

Citation

Koivusalo, Antti, et al. "Morbidity After Surgical Treatment of Isolated Intestinal Perforation and Necrotizing Enterocolitis Is Similar in Preterm Infants Weighing Less Than 1500 G." Journal of Pediatric Surgery, vol. 45, no. 2, 2010, pp. 319-22; discussion 323.
Koivusalo A, Pakarinen M, Rintala R. Morbidity after surgical treatment of isolated intestinal perforation and necrotizing enterocolitis is similar in preterm infants weighing less than 1500 g. J Pediatr Surg. 2010;45(2):319-22; discussion 323.
Koivusalo, A., Pakarinen, M., & Rintala, R. (2010). Morbidity after surgical treatment of isolated intestinal perforation and necrotizing enterocolitis is similar in preterm infants weighing less than 1500 g. Journal of Pediatric Surgery, 45(2), 319-22; discussion 323. https://doi.org/10.1016/j.jpedsurg.2009.10.067
Koivusalo A, Pakarinen M, Rintala R. Morbidity After Surgical Treatment of Isolated Intestinal Perforation and Necrotizing Enterocolitis Is Similar in Preterm Infants Weighing Less Than 1500 G. J Pediatr Surg. 2010;45(2):319-22; discussion 323. PubMed PMID: 20152344.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Morbidity after surgical treatment of isolated intestinal perforation and necrotizing enterocolitis is similar in preterm infants weighing less than 1500 g. AU - Koivusalo,Antti, AU - Pakarinen,Mikko, AU - Rintala,Risto, PY - 2009/10/13/received PY - 2009/10/27/accepted PY - 2010/2/16/entrez PY - 2010/2/16/pubmed PY - 2010/4/23/medline SP - 319-22; discussion 323 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 45 IS - 2 N2 - INTRODUCTION: Isolated intestinal perforation (IIP) and necrotizing enterocolitis (NEC) seem to be separate diseases, though their surgical treatment is similar. We compared the morbidity after surgery for IIP and NEC in preterm infants (birth weight <1500 g). PATIENTS AND METHODS: Isolated intestinal perforation was defined as intestinal perforation with associated necrosis less than 5% of bowel length and NEC as necrosis of 5% or more of bowel length +/- perforation. Outcome measures included time to full enteral feeds, incidence of total parenteral nutrition-associated cholestasis, and nutritional and neurologic status up to 60 months of age. Data are quoted as median (range). MAIN RESULTS: Sixty-one surviving patients treated between 1986 and 2006 were retrospectively reviewed (IIP: n = 32 versus NEC: n = 29). Median % resection of small and large bowel in IIP and NEC was 2% (1%-22%) versus 12% (6%-32%), and 5% (2%-13%) versus 7% (2%-25%), respectively (P < .05 in both). There was no significant difference in gestational age, birth weight, incidence of cerebral hemorrhage, respiratory distress syndrome, or surgical technique (enterostomy or primary anastomosis). Median time to enteral feeds, incidence of total parenteral nutrition-associated cholestasis, length of ventilation, and ultimate nutritional and neurologic outcome did not differ statistically significantly between the groups. CONCLUSION: Surgery in NEC resulted in more extensive intestinal resection than in IIP. However, subsequent morbidity was similar in both groups. SN - 1531-5037 UR - https://www.unboundmedicine.com/medline/citation/20152344/Morbidity_after_surgical_treatment_of_isolated_intestinal_perforation_and_necrotizing_enterocolitis_is_similar_in_preterm_infants_weighing_less_than_1500_g_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(09)00866-5 DB - PRIME DP - Unbound Medicine ER -