Comparison of acute abdominal surgical outcomes of extremely-low- birth-weight neonates according to differential diagnosis

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Abstract

Background: Improvements in perinatal intensive care have improved survival of extremelylow- birth-weight (ELBW) neonates, although the risk of acute abdomen has increased. The differential diagnosis resulting in abdominal surgery can be categorized into necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), meconium-related ileus (MRI), and meconium non-related ileus (MNRI). The purpose of this study was to review our experience with abdominal surgery for ELBW neonates, and to evaluate characteristics and prognosis according to the differential diagnosis. Methods: Medical records of ELBW neonates treated between 2003 and 2015 were retrospectively reviewed. Results: Of 805 ELBW neonates, 65 (8.1%) received abdominal surgery. The numbers of cases by disease category were 29 for NEC, 18 for SIP, 13 for MRI, and 5 for MNRI. Ostoma formation was performed in 61 (93.8%) patients; primary anastomosis without ostoma was performed in 4 (6.2%). All patients without ostoma formation experienced re-perforation of the anastomosis site. Seven patients had 30-day postoperative mortality (6 had NEC). Longterm survival of the surgical and non-surgical groups was not statistically different. NEC was a poor prognostic factor for survival outcome (P = 0.033). Conclusion: Abdominal surgery for ELBW neonates is feasible. Ostoma formation can lead to reduced complications compared to primary anastomosis.

Original languageEnglish
Article numbere222
JournalJournal of Korean Medical Science
Volume34
Issue number35
DOIs
StatePublished - 1 Sep 2019

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Low Birth Weight Infant
Meconium
Necrotizing Enterocolitis
Birth Weight
Ileus
Differential Diagnosis
Newborn Infant
Intestinal Perforation
Survival
Perinatal Care
Acute Abdomen
Critical Care
Medical Records
Mortality
Spontaneous Perforation

Keywords

  • Abdominal surgery
  • Extremely low birth weight
  • Meconium non-related ileus
  • Meconium related ileus
  • Necrotizing enterocolitis
  • Spontaneous intestinal perforation

Cite this

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title = "Comparison of acute abdominal surgical outcomes of extremely-low- birth-weight neonates according to differential diagnosis",
abstract = "Background: Improvements in perinatal intensive care have improved survival of extremelylow- birth-weight (ELBW) neonates, although the risk of acute abdomen has increased. The differential diagnosis resulting in abdominal surgery can be categorized into necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), meconium-related ileus (MRI), and meconium non-related ileus (MNRI). The purpose of this study was to review our experience with abdominal surgery for ELBW neonates, and to evaluate characteristics and prognosis according to the differential diagnosis. Methods: Medical records of ELBW neonates treated between 2003 and 2015 were retrospectively reviewed. Results: Of 805 ELBW neonates, 65 (8.1{\%}) received abdominal surgery. The numbers of cases by disease category were 29 for NEC, 18 for SIP, 13 for MRI, and 5 for MNRI. Ostoma formation was performed in 61 (93.8{\%}) patients; primary anastomosis without ostoma was performed in 4 (6.2{\%}). All patients without ostoma formation experienced re-perforation of the anastomosis site. Seven patients had 30-day postoperative mortality (6 had NEC). Longterm survival of the surgical and non-surgical groups was not statistically different. NEC was a poor prognostic factor for survival outcome (P = 0.033). Conclusion: Abdominal surgery for ELBW neonates is feasible. Ostoma formation can lead to reduced complications compared to primary anastomosis.",
keywords = "Abdominal surgery, Extremely low birth weight, Meconium non-related ileus, Meconium related ileus, Necrotizing enterocolitis, Spontaneous intestinal perforation",
author = "Jeik Byun and Kim, {Hyun Young} and Jung, {Sung Eun} and Yang, {Hee Beom} and Kim, {Ee Kyung} and Shin, {Seung Han} and Kim, {Han Suk}",
year = "2019",
month = "9",
day = "1",
doi = "10.3346/jkms.2019.34.e222",
language = "English",
volume = "34",
journal = "Journal of Korean medical science",
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publisher = "Korean Academy of Medical Science",
number = "35",

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TY - JOUR

T1 - Comparison of acute abdominal surgical outcomes of extremely-low- birth-weight neonates according to differential diagnosis

AU - Byun, Jeik

AU - Kim, Hyun Young

AU - Jung, Sung Eun

AU - Yang, Hee Beom

AU - Kim, Ee Kyung

AU - Shin, Seung Han

AU - Kim, Han Suk

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Background: Improvements in perinatal intensive care have improved survival of extremelylow- birth-weight (ELBW) neonates, although the risk of acute abdomen has increased. The differential diagnosis resulting in abdominal surgery can be categorized into necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), meconium-related ileus (MRI), and meconium non-related ileus (MNRI). The purpose of this study was to review our experience with abdominal surgery for ELBW neonates, and to evaluate characteristics and prognosis according to the differential diagnosis. Methods: Medical records of ELBW neonates treated between 2003 and 2015 were retrospectively reviewed. Results: Of 805 ELBW neonates, 65 (8.1%) received abdominal surgery. The numbers of cases by disease category were 29 for NEC, 18 for SIP, 13 for MRI, and 5 for MNRI. Ostoma formation was performed in 61 (93.8%) patients; primary anastomosis without ostoma was performed in 4 (6.2%). All patients without ostoma formation experienced re-perforation of the anastomosis site. Seven patients had 30-day postoperative mortality (6 had NEC). Longterm survival of the surgical and non-surgical groups was not statistically different. NEC was a poor prognostic factor for survival outcome (P = 0.033). Conclusion: Abdominal surgery for ELBW neonates is feasible. Ostoma formation can lead to reduced complications compared to primary anastomosis.

AB - Background: Improvements in perinatal intensive care have improved survival of extremelylow- birth-weight (ELBW) neonates, although the risk of acute abdomen has increased. The differential diagnosis resulting in abdominal surgery can be categorized into necrotizing enterocolitis (NEC), spontaneous intestinal perforation (SIP), meconium-related ileus (MRI), and meconium non-related ileus (MNRI). The purpose of this study was to review our experience with abdominal surgery for ELBW neonates, and to evaluate characteristics and prognosis according to the differential diagnosis. Methods: Medical records of ELBW neonates treated between 2003 and 2015 were retrospectively reviewed. Results: Of 805 ELBW neonates, 65 (8.1%) received abdominal surgery. The numbers of cases by disease category were 29 for NEC, 18 for SIP, 13 for MRI, and 5 for MNRI. Ostoma formation was performed in 61 (93.8%) patients; primary anastomosis without ostoma was performed in 4 (6.2%). All patients without ostoma formation experienced re-perforation of the anastomosis site. Seven patients had 30-day postoperative mortality (6 had NEC). Longterm survival of the surgical and non-surgical groups was not statistically different. NEC was a poor prognostic factor for survival outcome (P = 0.033). Conclusion: Abdominal surgery for ELBW neonates is feasible. Ostoma formation can lead to reduced complications compared to primary anastomosis.

KW - Abdominal surgery

KW - Extremely low birth weight

KW - Meconium non-related ileus

KW - Meconium related ileus

KW - Necrotizing enterocolitis

KW - Spontaneous intestinal perforation

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JO - Journal of Korean medical science

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