Surgical management of necrotising enterocolitis in Sweden : A national cohort study
Svenningsson, Anna ; Borg, Helena ; Hagander, Lars LU
and Engstrand Lilja, Helene
(2023)
In Acta Paediatrica, International Journal of Paediatrics
112(8).
p.1683-1688
- Abstract
Aim: Necrotising enterocolitis (NEC) is the dominating surgical emergency in preterm neonates. The aims were to investigate indications, surgical management and mortality for surgically treated neonates with NEC. Methods: Data were retrieved from the Swedish Neonatal Quality Register for Swedish neonates with surgically treated NEC from 1 January 2017 to 31 December 2021. Diagnosis was validated by surgical records and histopathology. Neonates with isolated spontaneous intestinal perforation were excluded. Results: In total, 109 neonates were included. Median gestational age was 25 weeks (22–38), and median birth weight was 771 g (269–3920). Preoperative pneumoperitoneum was found in 32%, portal venous gas in 25% and clinical... (More)
Aim: Necrotising enterocolitis (NEC) is the dominating surgical emergency in preterm neonates. The aims were to investigate indications, surgical management and mortality for surgically treated neonates with NEC. Methods: Data were retrieved from the Swedish Neonatal Quality Register for Swedish neonates with surgically treated NEC from 1 January 2017 to 31 December 2021. Diagnosis was validated by surgical records and histopathology. Neonates with isolated spontaneous intestinal perforation were excluded. Results: In total, 109 neonates were included. Median gestational age was 25 weeks (22–38), and median birth weight was 771 g (269–3920). Preoperative pneumoperitoneum was found in 32%, portal venous gas in 25% and clinical deterioration on conservative treatment in 26% of the neonates. Among the 97 neonates presenting with small bowel necrosis, single-focal NEC occurred in 38 (39%), multifocal NEC in 35 (36%) and panintestinal NEC in 24 (25%). A primary anastomosis was performed in 10/87 (11%) of the neonates with bowel resection at primary surgery. Clip-and-drop technique was applied in 24/87 (28%).Mortality rate was 37%. Conclusion: Mortality was well comparable with earlier reports considering exclusion of spontaneous intestinal perforation (SIP) and the low gestational age of the study population. Resection of necrotic bowel with stoma formation was the dominating surgical method.
(Less)
- author
- Svenningsson, Anna
; Borg, Helena
; Hagander, Lars
LU
and Engstrand Lilja, Helene
- organization
- publishing date
- 2023-08
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- necrotising enterocolitis, portal venous gas, preterm, surgical neonates
- in
- Acta Paediatrica, International Journal of Paediatrics
- volume
- 112
- issue
- 8
- pages
- 6 pages
- publisher
- Wiley-Blackwell
- external identifiers
-
- pmid:37166423
- scopus:85159455581
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.16836
- language
- English
- LU publication?
- yes
- additional info
- Funding Information: This study was supported by HRH Crown Princess Lovisa's Foundation. Publisher Copyright: © 2023 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.
- id
- 532494e0-91cf-44fe-afaa-63360484f406
- date added to LUP
- 2024-01-15 11:20:23
- date last changed
- 2024-04-15 22:07:53
@article{532494e0-91cf-44fe-afaa-63360484f406,
abstract = {{<p>Aim: Necrotising enterocolitis (NEC) is the dominating surgical emergency in preterm neonates. The aims were to investigate indications, surgical management and mortality for surgically treated neonates with NEC. Methods: Data were retrieved from the Swedish Neonatal Quality Register for Swedish neonates with surgically treated NEC from 1 January 2017 to 31 December 2021. Diagnosis was validated by surgical records and histopathology. Neonates with isolated spontaneous intestinal perforation were excluded. Results: In total, 109 neonates were included. Median gestational age was 25 weeks (22–38), and median birth weight was 771 g (269–3920). Preoperative pneumoperitoneum was found in 32%, portal venous gas in 25% and clinical deterioration on conservative treatment in 26% of the neonates. Among the 97 neonates presenting with small bowel necrosis, single-focal NEC occurred in 38 (39%), multifocal NEC in 35 (36%) and panintestinal NEC in 24 (25%). A primary anastomosis was performed in 10/87 (11%) of the neonates with bowel resection at primary surgery. Clip-and-drop technique was applied in 24/87 (28%).Mortality rate was 37%. Conclusion: Mortality was well comparable with earlier reports considering exclusion of spontaneous intestinal perforation (SIP) and the low gestational age of the study population. Resection of necrotic bowel with stoma formation was the dominating surgical method.</p>}},
author = {{Svenningsson, Anna and Borg, Helena and Hagander, Lars and Engstrand Lilja, Helene}},
issn = {{0803-5253}},
keywords = {{necrotising enterocolitis; portal venous gas; preterm; surgical neonates}},
language = {{eng}},
number = {{8}},
pages = {{1683--1688}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Paediatrica, International Journal of Paediatrics}},
title = {{Surgical management of necrotising enterocolitis in Sweden : A national cohort study}},
url = {{http://dx.doi.org/10.1111/apa.16836}},
doi = {{10.1111/apa.16836}},
volume = {{112}},
year = {{2023}},
}