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By Alejandro Peñarrieta Daher Pediatric Surgeon / Neonatal Surgeon
Nigel J Hall, Simon Eaton, Mark J Peters, Melanie P Hiorns, Nicholas Alexander, Denis V Azzopardi, Agostino Pierro
OBJECTIVES: Necrotizing enterocolitis (NEC) with multiple organ dysfunction syndrome (MODS) carries significant morbidity and mortality. There is extensive experimental evidence to support investigation of therapeutic hypothermia in infants with these conditions. We aimed to establish the feasibility and safety of mild hypothermia in preterm neonates with NEC and MODS as a prelude to a randomized trial. METHODS: This was a prospective, nonrandomized pilot study of 15 preterm infants who were referred for surgical intervention of advanced NEC and failure of at least 3 organs...
February 2010: Pediatrics
Jonathan Durell, Nigel J Hall, Melanie Drewett, Kujan Paramanantham, David Burge
OBJECTIVE: Identify the proportion of infants born at <26 completed weeks' gestation who require emergency laparotomy, and review the surgical pathology, incidence of subsequent surgical procedures and outcome. DESIGN: Retrospective cohort review. SETTING: Tertiary neonatal surgical unit. PATIENTS: All infants born at <26 weeks' gestation in a neonatal network over an 8-year period. RESULTS: Of 381 infants, laparotomy was indicated in 61 (16%) and performed in 57...
November 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
Debasish Bijoykrishna Banerjee, Hasanthi Vithana, Shilpa Sharma, Thomas Tat Ming Tsang
Newborns undergoing surgery for necrotizing enterocolitis (NEC) often require a stoma. Currently, there is no consensus regarding the best time for stoma closure (SC). Our aim was to determine the outcomes of early versus late closure. METHODS: Retrospective analysis of patients who underwent SC following stoma formation for NEC between Jan 2009 and July 2015 was done. Early (EC) versus late closure (LC) was defined as less than 10 weeks versus at or after 10 weeks of stoma formation...
July 2017: Pediatric Surgery International
Lindsay J Talbot, Robert D Sinyard, Kristy L Rialon, Brian R Englum, Elizabeth T Tracy, Henry E Rice, Obinna O Adibe
PURPOSE: Neonates after emergent enterostomy creation frequently require reversal at low weight because of complications including cholestasis, dehydration, dumping, failure to thrive, and failure to achieve enteral independence. We investigated whether stoma reversal at low weight (< 2.5kg) is associated with poor surgical outcomes. METHODS: Patients who underwent enterostomy reversal from 2005 to 2013 at less than 6months old were identified in our institutional database...
January 2017: Journal of Pediatric Surgery
Augusto Zani, Giuseppe Lauriti, Qi Li, Agostino Pierro
Aim  Some infants with necrotizing enterocolitis (NEC) undergoing surgery require the formation of a stoma. The timing of stoma closure in these patients remains controversial. Our aim was to determine whether the different timing of closure had an impact on patient outcome. Methods  Using a defined search strategy (PubMed, Embase, and Web of Science), two investigators (Q.L. and G.L.) independently identified studies comparing early stoma closure (ESC, before 8 weeks from stoma formation) versus late stoma closure (LSC, after 8 weeks) in infants with NEC...
February 2017: European Journal of Pediatric Surgery
Masahito Sato, Yoshinori Hamada, Miyuki Kohno, Kazuya Ise, Keiichi Uchida, Hiromi Ogata, Hiroaki Masuyama, Yoshiki Morotomi, Masao Yasufuku, Motoshi Wada
PURPOSE: The purpose of this study is to identify the current clinical features of neonatal gastrointestinal perforation in Japan. METHODS: A questionnaire about cases of neonatal gastrointestinal perforation treated in recent 5 years was sent to participating institutions of the Japanese Society of Pediatric Surgeons (JSPS). RESULTS: Five hundred and thirty-six neonates with gastrointestinal perforation were treated. They consisted of 42 patients with gastric rupture/perforation (GR), 33 patients with intestinal atresia/stenosis (IA), 3 patients with malrotation (ML), 118 patients with necrotizing enterocolitis (NEC), 160 patients with focal intestinal perforation (FIP), 46 patients with meconium-related ileus (MRI), 77 patients with meconium peritonitis (MP), and 57 patients with other conditions...
January 2017: Pediatric Surgery International
Shireen A Nah, Hock-Lim Tan, Riana P Tamba, Dayang A Aziz, Nurliza Azzam
BACKGROUND: Necrotizing enterocolitis has a wide clinical spectrum of manifestation. We report a novel method of managing focal isolated perforation in necrotizing enterocolitis by using diagnostic laparoscopy to localize the site of perforation and by making a microincision over the perforation to perform exteriorization or limited resection and primary anastomosis. METHODS: We included low-birth weight infants presenting with sudden clinical deterioration and pneumoperitoneum...
February 2011: Journal of Pediatric Surgery
Agostino Pierro, Simon Eaton, Clare M Rees, Paolo De Coppi, Edward M Kiely, Mark J Peters, Joe Brierley
No abstract text is available yet for this article.
November 2010: Journal of Pediatric Surgery
F H Heida, M H J Loos, L Stolwijk, B J C Te Kiefte, S J van den Ende, W Onland, R R van Rijn, R Dikkers, F A M van den Dungen, E M W Kooi, A F Bos, J B F Hulscher, R Bakx
INTRODUCTION: Survivors of necrotizing enterocolitis (NEC) often develop a post-NEC intestinal stricture, causing severe and prolonged morbidity. OBJECTIVES: We first aimed to determine the incidence of post-NEC strictures. Second, we aimed to determine risk factors associated with intestinal post-NEC strictures. MATERIALS AND METHODS: A total of 441 patients diagnosed with NEC Bell's stage ≥2 were retrospectively included in three academic pediatric surgical centers between January 2005 and January 2013...
July 2016: Journal of Pediatric Surgery
Anthony J Munaco, Michelle A Veenstra, Evan Brownie, Logan A Danielson, Kartheek B Nagappala, Michael D Klein
Up to half of all patients with necrotizing enterocolitis require acute surgical treatment. Determining when to operate on these patients can be challenging. Utilizing a combination of clinical and metabolic indicators, we sought to identify the optimal timing of surgical intervention. A retrospective chart review was conducted on patients with necrotizing enterocolitis from 2001 to 2010. Previously validated clinical (abdominal erythema, palpable abdominal mass, hypotension), radiographic (pneumoperitoneum, portal venous gas, fixed bowel loop, severe pneumatosis intestinalis), and laboratory (acidosis, bacteremia, hyponatremia, bandemia, neutropenia, thrombocytopenia) indicators were assessed for the ability to predict the need for acute surgical intervention as a simple indicator score, based on the sum of the indicators listed above...
May 2015: American Surgeon
Anne G J F van Zoonen, Maarten Schurink, Arend F Bos, Erik Heineman, Jan B F Hulscher
BACKGROUND: An ostomy seems a safe alternative in neonates with an acute abdomen when immediate restoration of bowel continuity is deemed undesirable. Faced with several complications in our center, and the feeling we are not the only center with these complications, we decided to assess the rate and type of complications after both ostomy creation and closure. METHODS: All data regarding neonates (<30 days of age) who underwent a laparotomy for a suspected abdominal emergency in the period 2000 to 2010 were retrospectively analyzed...
August 2012: European Journal of Pediatric Surgery
Tricia J Johnson, Aloka L Patel, Harold R Bigger, Janet L Engstrom, Paula P Meier
BACKGROUND: Necrotizing enterocolitis (NEC) is a costly morbidity in very low birth weight (VLBW; <1,500 g birth weight) infants that increases hospital length of stay and requires expensive treatments. OBJECTIVES: To evaluate the cost of NEC as a function of dose and exposure period of human milk (HM) feedings received by VLBW infants during the neonatal intensive care unit (NICU) hospitalization and determine the drivers of differences in NICU hospitalization costs for infants with and without NEC...
2015: Neonatology
Etienne Suply, Marc-David Leclair, Michel Neunlist, Jean-Christophe Roze, Cyril Flamant
BACKGROUND: Necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) are serious abdominal conditions that affect preterm infants but are poorly understood. This single-center retrospective study was performed to identify the factors associated with NEC and SIP. METHODS: This study involved 3,464 preterm infants recruited over 16 years. A total of 136 NEC and 24 SIP were analyzed and adjusted odds ratios (aOR) were determined by logistic regression...
December 2015: European Journal of Pediatric Surgery
Augusto Zani, Simon Eaton, Prem Puri, Risto Rintala, Marija Lukac, Pietro Bagolan, Joachim F Kuebler, Michael E Hoellwarth, Rene Wijnen, Juan Tovar, Agostino Pierro
AIM: The aim of this study is to define patterns in the management of necrotizing enterocolitis (NEC). METHODS: A total of 80 delegates (81% senior surgeons) from 29 (20 European) countries completed a survey at the European Pediatric Surgeons' Association 2013 annual meeting. RESULTS: Overall, 59% surgeons work in centers where>10 cases of NEC are treated per year. DIAGNOSIS: 76% surgeons request both anteroposterior and lateral abdominal X-rays, which are performed at regular intervals by 66%; 50% surgeons also request Doppler ultrasonography; most frequently used biochemical markers are platelets (99% of surgeons), C-reactive protein (90%), and white cell count (83%)...
February 2015: European Journal of Pediatric Surgery
Marcelo Martinez-Ferro, Steven Rothenberg, Shawn St Peter, Horacio Bignon, George Holcomb
The current report is a multicenter study of a series of infants who developed colonic strictures (CS) as a sequelae of necrotizing enterocolitis (NEC) and who were treated successfully with laparoscopic intestinal resection and primary anastomosis. During 2005-2008, 11 neonates (gestational ages, 32-38 weeks), with a mean birth weight of 1.7 kg (range, 0.96-2.2) and a mean weight at operation of 3.04 kg (range, 1.6-4.4 were approached laparoscopically, following the diagnosis of a post-NEC-CS. The two surgical techniques were: 1) laparoscopic mobilization with extracorporeal resection and anastomosis (LERA) in 4 (36%) and 2) laparoscopic mobilization with intracorporeal resection and anastomosis (LIRA) in 7 (64%) patients...
June 2010: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Ali Yikilmaz, Nigel J Hall, Alan Daneman, J Ted Gerstle, Oscar M Navarro, Rahim Moineddin, Hazel Pleasants, Agostino Pierro
BACKGROUND/AIM: Established indications for surgery in necrotizing enterocolitis (NEC) are pneumoperitoneum and failure to improve or clinical deterioration with medical treatment alone. It has been proposed that infants with intestinal necrosis may benefit from surgery in the absence of one of these indications yet the diagnosis of definitive intestinal necrosis is challenging. Recent data suggest that abdominal ultrasound (US) examination focused on the gastrointestinal tract and the peritoneal cavity may be of utility in this regard...
December 2014: Pediatric Surgery International
Stephanie Sea, Teerin Meckmongkol, Matthew L Moront, Shaheen Timmapuri, Rajeev Prasad, Marshall Z Schwartz, L Grier Arthur
PURPOSE: Necrotizing enterocolitis (NEC) requiring surgical intervention is associated with mortality rates approaching 50%. We evaluated outcomes of patients that underwent surgical treatment for NEC with vacuum-assisted closure (VAC) of the abdomen as compared with traditional laparotomy, bowel resection, and ostomy creation. METHODS: A retrospective review identified 26 patients from 2007 to 2012 with NEC. Overall, 17 patients were treated with laparotomy, and 9 were treated with laparotomy and VAC (LapVac)...
February 2015: European Journal of Pediatric Surgery
Michael Singh, Anthony Owen, Sobbia Gull, Antonino Morabito, Adrian Bianchi
BACKGROUND: Traditionally, a stoma is established after resection of perforated or necrotic intestine for isolated intestinal perforation (IIP) and necrotizing enterocolitis (NEC). We compared the outcome of resection and anastomosis (RA) with stoma formation (RS). METHODS: Sixty-eight neonates undergoing laparotomy for IIP (n = 20), NEC (n = 43), and indeterminate cause (n = 5) were reviewed retrospectively. Intestinal resection was followed by either anastomosis or stoma...
April 2006: Journal of Pediatric Surgery
Naomi J Wright, Mandela Thyoka, Edward M Kiely, Agostino Pierro, Paolo De Coppi, Kate M K Cross, David D Drake, Mark J Peters, Joe I Curry
PURPOSE: To evaluate outcomes in critically ill neonates with necrotising enterocolitis (NEC) undergoing a laparotomy in the neonatal intensive care unit (NICU). METHODS: This is a retrospective review of neonates diagnosed with NEC who underwent a laparotomy on NICU between 2001 and 2011. Demographic, diagnostic, operative and outcome data were analysed. Nonparametric comparison was used. Data are reported as median (range). RESULTS: 221 infants with NEC were referred for surgical evaluation; 182 (82%) underwent surgery; 15 (8%) required a laparotomy on NICU...
August 2014: Journal of Pediatric Surgery
L Fasoli, R A Turi, L Spitz, E M Kiely, D Drake, A Pierro
PURPOSE: The aim of this study was to evaluate the results of surgical treatment of necrotizing enterocolitis (NEC) according to the extent of disease and to establish if resection of the ileocecal valve represents a poor prognostic factor. METHODS: The authors reviewed all cases of NEC (n = 161) treated in our hospital during the last 11 years; of these, 83 required surgical intervention. Definitions used by the authors include isolated, disease in a single intestinal segment; multifocal, disease in two or more intestinal segments; and pan-intestinal, majority of small and large bowel involved...
July 1999: Journal of Pediatric Surgery
2014-07-20 16:43:03
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