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.
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。