Comparison of Acute Abdominal Surgical Outcomes of Extremely-Low-Birth-Weight Neonates according to Differential Diagnosis
Journal of Korean Medical Science
;
: e222-2019.
Article
in English
| WPRIM
| ID: wpr-765068
ABSTRACT
BACKGROUND:
Improvements in perinatal intensive care have improved survival of extremely-low-birth-weight (ELBW) neonates, although the risk of acute abdomen has increased. The differential diagnosis resulting in abdominal surgery can be categorized into necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), meconium-related ileus (MRI), and meconium non-related ileus (MNRI). The purpose of this study was to review our experience with abdominal surgery for ELBW neonates, and to evaluate characteristics and prognosis according to the differential diagnosis.METHODS:
Medical records of ELBW neonates treated between 2003 and 2015 were retrospectively reviewed.RESULTS:
Of 805 ELBW neonates, 65 (8.1%) received abdominal surgery. The numbers of cases by disease category were 29 for NEC, 18 for SIP, 13 for MRI, and 5 for MNRI. Ostoma formation was performed in 61 (93.8%) patients; primary anastomosis without ostoma was performed in 4 (6.2%). All patients without ostoma formation experienced re-perforation of the anastomosis site. Seven patients had 30-day postoperative mortality (6 had NEC). Long-term survival of the surgical and non-surgical groups was not statistically different. NEC was a poor prognostic factor for survival outcome (P = 0.033).CONCLUSION:
Abdominal surgery for ELBW neonates is feasible. Ostoma formation can lead to reduced complications compared to primary anastomosis.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Magnetic Resonance Imaging
/
Medical Records
/
Retrospective Studies
/
Mortality
/
Enterocolitis, Necrotizing
/
Critical Care
/
Ileus
/
Diagnosis, Differential
/
Abdomen, Acute
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Humans
/
Infant, Newborn
Language:
English
Journal:
Journal of Korean Medical Science
Year:
2019
Type:
Article
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