Kenji Santo, Yuichi Takama, Marie Todo, Hisashi Yagi, Shuto Ikeda, Yuko Tanaka, Hiroyuki Ichiba, Masafumi Kamiyama
{"title":"极低出生体重儿粪相关肠梗阻的积极灌肠和手术治疗。","authors":"Kenji Santo, Yuichi Takama, Marie Todo, Hisashi Yagi, Shuto Ikeda, Yuko Tanaka, Hiroyuki Ichiba, Masafumi Kamiyama","doi":"10.1007/s00383-025-06151-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).</p><p><strong>Methods: </strong>Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15 years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the \"Old\" group (O, n = 56; treated before March 2018) and the \"New\" group (N, n = 35; treated after April 2018).</p><p><strong>Results: </strong>The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.</p><p><strong>Conclusions: </strong>Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.</p>","PeriodicalId":19832,"journal":{"name":"Pediatric Surgery International","volume":"41 1","pages":"248"},"PeriodicalIF":1.6000,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Aggressive enema and surgery for meconium-related ileus in extremely low-birth-weight infants.\",\"authors\":\"Kenji Santo, Yuichi Takama, Marie Todo, Hisashi Yagi, Shuto Ikeda, Yuko Tanaka, Hiroyuki Ichiba, Masafumi Kamiyama\",\"doi\":\"10.1007/s00383-025-06151-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).</p><p><strong>Methods: </strong>Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15 years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the \\\"Old\\\" group (O, n = 56; treated before March 2018) and the \\\"New\\\" group (N, n = 35; treated after April 2018).</p><p><strong>Results: </strong>The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.</p><p><strong>Conclusions: </strong>Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.</p>\",\"PeriodicalId\":19832,\"journal\":{\"name\":\"Pediatric Surgery International\",\"volume\":\"41 1\",\"pages\":\"248\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-08-17\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pediatric Surgery International\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00383-025-06151-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pediatric Surgery International","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00383-025-06151-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
Aggressive enema and surgery for meconium-related ileus in extremely low-birth-weight infants.
Purpose: To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).
Methods: Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15 years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the "Old" group (O, n = 56; treated before March 2018) and the "New" group (N, n = 35; treated after April 2018).
Results: The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.
Conclusions: Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.
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