Outcomes of Surgical Management for Necrotizing Enterocolitis: an 11-year Experience

Authors

  • Sithichok Laohawilai Department of Surgery, Khon Kaen Hospital, Khon Kaen
  • Thetiya Wirifi Department of Surgery, Khon Kaen Hospital, Khon Kaen
  • Benjaporn Silaruks Department of Surgery, Khon Kaen Hospital, Khon Kaen

Keywords:

Necrotizing enterocolitis, Primary peritoneal drainage, Primary exploratory laparotomy, Necrotic bowel resection, Enterostomy

Abstract

Background: Necrotizing enterocolitis (NEC) is a serious disease in neonates and requires surgical treatment in cases with complications. The purpose of this study was to review outcomes of NEC patients treated by various procedures during an 11-year period.

Materials and Methods: A retrospective cohort study of patients with NEC treated at Khon Kaen Hospital between January 2009 and December 2019 was conducted. Medical records of patients were abstracted for clinical characteristics and presentations, laboratory findings, radiologic studies and results of treatment.

Results: Seventy-three NEC patients (40 males and 33 females) was available for the study. Sixty-one cases (84%) were managed by medical treatment and 12 cases (16.4%) required surgery because of complications due to intestinal perforation and peritonitis. Of the 12 surgical NEC, 10 cases (83%) were premature (median gestational age, 29 weeks) and 10 were low birth weight infants (median birth weight, 1263 grams). Nine cases (75%) had a serious condition treated by primary peritoneal drainage (PPD) and 4 cases survived (44%). Three cases underwent primary exploratory laparotomy (PEL) – 2 had necrotic bowel resection with enterostomy, and one had primary anastomosis – and only one survived. The overall mortality of surgical NEC was 60% (7 of 12 cases), and the mortality rate of medical NEC was 12% (7 of 61 cases).

Conclusion: NEC patients with serious complications including intestinal perforation and peritonitis require surgical treatment. PPD was done more common than PEL because of severely – ill patients with extremely and very low birth weight. The overall mortality of surgical NEC remains high, at 50%.

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Published

2022-05-05

How to Cite

1.
Laohawilai S, Wirifi T, Silaruks B. Outcomes of Surgical Management for Necrotizing Enterocolitis: an 11-year Experience. Thai J Surg [Internet]. 2022 May 5 [cited 2022 Dec. 9];43(1):3-11. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/251109

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Original Articles