Operational Outcomes of Bowel Perforation Due to Necrotizing Enterocolitis in Preterm Infants of Less than or Equal to 25 Weeks' Gestational Age

ABSTRACT

PURPOSE: Even though the improved survival rate of extremely preterm infants, the incidence of necrotizing enterocolitis (NEC) requiring operation has not decreased. Thus, this report demonstrates our experience of clinical course of bowel perforation due to necrotizing enterocolitis in preterm infants of less than or equal to 25 weeks' gestational age. METHODS: We retrospectively reviewed the medical records of 38 infants who underwent an operation for bowel perforation because of NEC from January 2000 to December 2012 at Samsung Medical Center. RESULTS: 38 infants out of a total 53 infants diagnosed with NEC required operation due to bowel perforation. The mortality rate was 44.7% (alive group n=21, dead group n=17). Age when NEC was diagnosed 18.4+/-14.8 days, mean enteral feeding volume on day of early NEC was 16.7+/-8.6 cc/kg. The platelet count was significantly lower in the dead group. All alive infants, with the exception of one infant who underwent total small bowel resection, were successful in full enteral feeding. Ostomy closure was performed 159.0+/-43.6 days after the initial operation. The average body weight at ostomy closure operation was 3,566+/-1,118 g. CONCLUSION: 71.7% of the premature with a gestational age of 25weeks or less with a diagnosis of NEC required operation due to bowel perforation. But the infants who survived showed successful establishment of full enteral feeding and achieved catch up growth at 18 months of corrected gestational age.