Abstract：
The aim of this study was to assess outcomes of peritoneal drainage and laparotomy in the management of intestinal perforation secondary to necrotizing enterocolitis (NEC) and spontaneous intestinal perforation.
A retrospective review of all preterm infants (birthweight ≤1500 g) who underwent surgical intervention (peritoneal drainage and/or laparotomy) for intestinal perforation between March 2010 and March 2020.
A total of 43 infants who underwent surgical intervention for intestinal perforation were included [19 (44%) with NEC and 24 (56%) with spontaneous intestinal perforation]. Peritoneal drainage was more commonly placed as the initial surgical procedure for management of spontaneous intestinal perforation compared with surgical NEC [23 (96%) vs. 11 (58%), p = 0.003]. Mortality was greater for infants who were initially managed with peritoneal drainage [11 (32%)] compared with those who underwent primary laparotomy [2 (22%), p = 0.5].
Initial surgical management of intestinal perforation is more often according to underlying pathology. Our data support primary laparotomy for infants with perforated NEC.
A retrospective review of all preterm infants (birthweight ≤1500 g) who underwent surgical intervention (peritoneal drainage and/or laparotomy) for intestinal perforation between March 2010 and March 2020.
A total of 43 infants who underwent surgical intervention for intestinal perforation were included [19 (44%) with NEC and 24 (56%) with spontaneous intestinal perforation]. Peritoneal drainage was more commonly placed as the initial surgical procedure for management of spontaneous intestinal perforation compared with surgical NEC [23 (96%) vs. 11 (58%), p = 0.003]. Mortality was greater for infants who were initially managed with peritoneal drainage [11 (32%)] compared with those who underwent primary laparotomy [2 (22%), p = 0.5].
Initial surgical management of intestinal perforation is more often according to underlying pathology. Our data support primary laparotomy for infants with perforated NEC.
摘要：
目的：本研究的目的是评估腹膜引流和开腹手术治疗坏死性小肠结肠炎（NEC）继发肠穿孔和自发性肠穿孔的结局。
方法：回顾性分析2010年3月至2020年3月期间所有因肠穿孔而接受手术干预（腹膜引流和/或剖腹手术）的早产儿（出生体重≤1500g）。
结果：共43例接受肠穿孔手术干预的婴儿被纳入[19例（44%）NEC和24例（56%）自发性肠穿孔]。与手术NEC相比，腹膜引流更常用于治疗自发性肠穿孔的初始外科手术[23（96％）与11（58%），p=0.003]。与接受初次剖腹手术的婴儿相比，最初接受腹膜引流治疗的婴儿的死亡率更高[11（32％）][2（22％），p=0.5]。
结论：肠穿孔的初始手术治疗更多是根据基础病理。我们的数据支持NEC穿孔婴儿的初次剖腹手术。
方法：回顾性分析2010年3月至2020年3月期间所有因肠穿孔而接受手术干预（腹膜引流和/或剖腹手术）的早产儿（出生体重≤1500g）。
结果：共43例接受肠穿孔手术干预的婴儿被纳入[19例（44%）NEC和24例（56%）自发性肠穿孔]。与手术NEC相比，腹膜引流更常用于治疗自发性肠穿孔的初始外科手术[23（96％）与11（58%），p=0.003]。与接受初次剖腹手术的婴儿相比，最初接受腹膜引流治疗的婴儿的死亡率更高[11（32％）][2（22％），p=0.5]。
结论：肠穿孔的初始手术治疗更多是根据基础病理。我们的数据支持NEC穿孔婴儿的初次剖腹手术。
