Adinda G H Pijpers, Ceren Imren, Otis C van Varsseveld, Jan B F Hulscher, Elisabeth M W Kooi, Chris H P van den Akker, Joost van Schuppen, Jos W R Twisk, Joep P M Derikx, Marijn J Vermeulen, Claudia M G Keyzer-Dekker
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引用次数: 0
摘要
背景：超过一半的坏死性小肠结肠炎（NEC）早产儿需要手术治疗，因此了解短期术后结果和并发症发生率至关重要。因此，本研究旨在提供NEC术后30天并发症的概述。其次，确定了轻微和主要短期术后并发症的危险因素。方法：这项回顾性研究纳入了所有早产儿（GA）。结果：在326例患者中，204例接受了造口术，80例进行了一期吻合，32例两者都进行了吻合。术后死亡率为19.0%。186例患者共发生并发症238例（57.1%），其中主要并发症118例（63.4%），次要并发症68例（36.6%）。最常见的并发症是脓毒症（19.4%）、造口相关（13.3%）和伤口裂开（11.3%）。从NEC诊断到手术期间的心血管支持是主要并发症（OR: 1.92, 95%-CI 1.19-3.08, p = 0.007）和轻微并发症造口的重要危险因素（OR: 6.73, 95%-CI 2.05-22.05, p = 0.002）。结论：本组术后并发症发生率为57.1%。我们发现，在NEC诊断和手术之间，心血管支持是主要并发症的危险因素，而造口是次要并发症的危险因素。这些发现为改善NEC结果的家长咨询提供了有价值的见解。证据水平：II。
Short-term postoperative complications in preterm neonates with surgical necrotizing enterocolitis: a multicenter retrospective cohort study.
Background: Over half of preterm neonates with necrotizing enterocolitis (NEC) require surgery, making it essential to understand short-term postoperative outcomes and complication rates. Therefore, this study aimed to provide an overview of 30-day postoperative complications for NEC. Secondary, risk factors for minor and major short-term postoperative complications were identified.
Methods: This retrospective study included all preterm infants (GA < 35w) surgically treated for NEC from 2008 to 2022. Postoperative complications were scored following the Clavien-Madadi classification. Risk factors were analyzed using multivariable logistic regression analysis.
Results: In this cohort of 326 patients, 204 received a stoma, 80 had a primary anastomosis, and 32 had both. Postoperative mortality was 19.0%. In total, 186 patients experienced 238 complications (57.1%), including 118 (63.4%) major and 68 (36.6%) minor complications. Most common complications were sepsis (19.4%), stoma-related (13.3%), and wound dehiscence (11.3%). Cardiovascular support between NEC diagnosis and surgery was a significant risk factor for major complications (OR: 1.92, 95%-CI 1.19-3.08, p = 0.007) and stoma creation for minor complications (OR: 6.73, 95%-CI 2.05-22.05, p = 0.002).
Conclusion: This study showed a postoperative complication rate of 57.1%. We found cardiovascular support between NEC diagnosis and surgery as risk factor for major complications and stoma creation as risk factor for minor complications. These findings provide valuable insights for improving parental counseling on NEC outcomes.
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
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