{"title":"早产儿坏死性小肠结肠炎一期吻合的疗效及远期随访","authors":"Y. Sweed","doi":"10.19080/AJPN.2020.09.555821","DOIUrl":null,"url":null,"abstract":"Objective: To investigate the safety and effectiveness of primary anastomosis (PA) in infants with complicated necrotizing enterocolitis (NEC) and the short and long-term outcomes, including the neurodevelopmental outcomes. Methods: A retrospective analysis of medical records of all infants diagnosed with NEC in the years 2000-2016. Long-term outcome data were taken from medical records and parental questionnaires. Results: Of 98 infants diagnosed with NEC, 40 were surgically treated (22 PA, 9 stoma, 9 peritoneal drainage (PD)). PA had shorter length of parenteral nutrition (20 vs. 34 days, p= 0.215), antibiotic treatment (10 vs. 14 days, p=0.053) and hospitalization (48 vs. 106 days, p=0.026) compared to stoma. Stoma group infants who needed more than one surgical intervention due to complications was three times higher (66% vs 22%, p= 0.038) and 57% of stoma infants developed short bowel syndrome compared to 33% of PA infants. There was no statistically significant difference between PA and stoma in mortality rate (27% vs 22%, p=1.00). Normal development at 1-2 years after discharge was found in 40% of PA and 14% of stoma. Severe neurodevelopmental impairment (NDI) was more common in stoma (70%) than in PA (20%). 70% of PA infants were integrated into a regular education framework compared to 28% of stoma. Conclusion: safe and effective surgical technique in the management of complicated NEC, with the same mortality rate as stoma, but, with lower morbidity in the short term and better long-term neurodevelopmental outcomes.","PeriodicalId":93160,"journal":{"name":"Academic journal of pediatric and neonatology","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2020-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Outcome of Primary Anastomosis and the Long Term Follow Up of Preterm Infants Undergoing Surgery for Necrotizing Enterocolitis\",\"authors\":\"Y. Sweed\",\"doi\":\"10.19080/AJPN.2020.09.555821\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: To investigate the safety and effectiveness of primary anastomosis (PA) in infants with complicated necrotizing enterocolitis (NEC) and the short and long-term outcomes, including the neurodevelopmental outcomes. Methods: A retrospective analysis of medical records of all infants diagnosed with NEC in the years 2000-2016. Long-term outcome data were taken from medical records and parental questionnaires. Results: Of 98 infants diagnosed with NEC, 40 were surgically treated (22 PA, 9 stoma, 9 peritoneal drainage (PD)). PA had shorter length of parenteral nutrition (20 vs. 34 days, p= 0.215), antibiotic treatment (10 vs. 14 days, p=0.053) and hospitalization (48 vs. 106 days, p=0.026) compared to stoma. Stoma group infants who needed more than one surgical intervention due to complications was three times higher (66% vs 22%, p= 0.038) and 57% of stoma infants developed short bowel syndrome compared to 33% of PA infants. There was no statistically significant difference between PA and stoma in mortality rate (27% vs 22%, p=1.00). Normal development at 1-2 years after discharge was found in 40% of PA and 14% of stoma. Severe neurodevelopmental impairment (NDI) was more common in stoma (70%) than in PA (20%). 70% of PA infants were integrated into a regular education framework compared to 28% of stoma. Conclusion: safe and effective surgical technique in the management of complicated NEC, with the same mortality rate as stoma, but, with lower morbidity in the short term and better long-term neurodevelopmental outcomes.\",\"PeriodicalId\":93160,\"journal\":{\"name\":\"Academic journal of pediatric and neonatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2020-04-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Academic journal of pediatric and neonatology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.19080/AJPN.2020.09.555821\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Academic journal of pediatric and neonatology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.19080/AJPN.2020.09.555821","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The Outcome of Primary Anastomosis and the Long Term Follow Up of Preterm Infants Undergoing Surgery for Necrotizing Enterocolitis
Objective: To investigate the safety and effectiveness of primary anastomosis (PA) in infants with complicated necrotizing enterocolitis (NEC) and the short and long-term outcomes, including the neurodevelopmental outcomes. Methods: A retrospective analysis of medical records of all infants diagnosed with NEC in the years 2000-2016. Long-term outcome data were taken from medical records and parental questionnaires. Results: Of 98 infants diagnosed with NEC, 40 were surgically treated (22 PA, 9 stoma, 9 peritoneal drainage (PD)). PA had shorter length of parenteral nutrition (20 vs. 34 days, p= 0.215), antibiotic treatment (10 vs. 14 days, p=0.053) and hospitalization (48 vs. 106 days, p=0.026) compared to stoma. Stoma group infants who needed more than one surgical intervention due to complications was three times higher (66% vs 22%, p= 0.038) and 57% of stoma infants developed short bowel syndrome compared to 33% of PA infants. There was no statistically significant difference between PA and stoma in mortality rate (27% vs 22%, p=1.00). Normal development at 1-2 years after discharge was found in 40% of PA and 14% of stoma. Severe neurodevelopmental impairment (NDI) was more common in stoma (70%) than in PA (20%). 70% of PA infants were integrated into a regular education framework compared to 28% of stoma. Conclusion: safe and effective surgical technique in the management of complicated NEC, with the same mortality rate as stoma, but, with lower morbidity in the short term and better long-term neurodevelopmental outcomes.