The clinical characteristics and prognostic factors of neonatal gastric perforation and rupture: a multicenter retrospective study in Japan.

IF 1.8 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2026-09-06 DOI:10.1007/s00383-026-06616-y

Toshio Harumatsu, Koshiro Sugita, Ayano Hidaka, Tsubasa Goshima, Shohei Yoshimura, Daisuke Masui, Tokuro Baba, Hirofumi Tomita, Naoki Shimojima, Tadashi Hatakeyama, Motofumi Torikai, Tatsuru Kaji, Satoshi Ieiri

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引用次数: 0

Abstract

Purpose: Neonatal gastric perforation is a life-threatening surgical emergency with high mortality rates. The confounding effect of tracheoesophageal fistula (TEF) on prognostic analyses remains inadequately addressed. This study aimed to identify the prognostic factors for in-hospital mortality using a multicenter analysis.

Methods: We conducted a retrospective study at six tertiary pediatric surgery centers in Japan, including all neonates who underwent surgical treatment for either gastric perforation or rupture between 1994 and 2025. Logistic regression and sensitivity analyses, excluding TEF cases, were performed.

Results: Thirty-seven patients were identified, with a median birth weight of 1202 g, of whom 56.8% had a very low birth weight. The overall mortality rate was 37.8% (14/37). On a multivariate analysis, TEF was the strongest independent prognostic factor (OR 51.85, 95% CI 3.26-824.6; p = 0.005). In the sensitivity analysis excluding TEF cases (n = 28), the age at surgery (OR 1.23, 95% CI 1.01-1.51; p = 0.041) and the perforation length (OR 1.09, 95% CI 1.00-1.18; p = 0.043) were significant predictors of mortality.

Conclusion: TEF is the strongest prognostic factor for neonatal gastric perforation. Excluding TEF confounding factors revealed the prognostic importance of the age at surgery and the perforation size, highlighting the value of early diagnosis and management.

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日本新生儿胃穿孔和破裂的临床特征和预后因素：一项多中心回顾性研究。

目的：新生儿胃穿孔是危及生命的外科急症，死亡率高。气管食管瘘（TEF）在预后分析中的混淆效应仍然没有得到充分的解决。本研究旨在通过多中心分析确定院内死亡率的预后因素。方法：我们在日本的六个三级儿科外科中心进行了一项回顾性研究，包括1994年至2025年间因胃穿孔或破裂接受手术治疗的所有新生儿。排除TEF病例，进行Logistic回归和敏感性分析。结果：37例患者，中位出生体重1202 g，其中56.8%为极低出生体重。总死亡率为37.8%（14/37）。在多变量分析中，TEF是最强的独立预后因素（OR 51.85, 95% CI 3.26-824.6; p = 0.005）。在排除TEF病例（n = 28）的敏感性分析中，手术年龄（OR 1.23, 95% CI 1.01-1.51; p = 0.041）和穿孔长度（OR 1.09, 95% CI 1.00-1.18; p = 0.043）是死亡率的重要预测因子。结论：TEF是新生儿胃穿孔最重要的预后因素。排除TEF混杂因素显示手术年龄和穿孔大小对预后的重要性，突出了早期诊断和治疗的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor