%0 Journal Article
%T Bedside laparotomy in newborns -A single institute experience.
%A Herle K
%A Jayaram H
%A Deb M
%A Bothra J
%A Kannaiyan L
%A Waghmare M
%A Krithiga AJ
%J J Pediatr Surg
%V 56
%N 12
%D Dec 2021
%M 33334555
%F 2.549
%R 10.1016/j.jpedsurg.2020.11.029
%X <B>OBJECTIVE: </B>Intra hospital transfer of sick newborns is known to cause adverse events with potential morbidity. Interventions at the bedside in a sick neonate can reduce the need for transport and in turn, potential hazards of transfer. Our single institute experience of performing bedside laparotomies in unstable newborns is reported here.<BR><B>METHODS: </B>Seven-year data was collected from electronic medical records. This was a retrospective comparative study with level III evidence. Twenty-eight neonates operated at bedside for intraabdominal sepsis due to Necrotising Enterocolitis (NEC), Spontaneous Intestinal Perforation (SIP), complicated meconium ileus and perforation secondary to atresias were included Group A. Group B had 60 neonates operated for similar indications in the conventional operation theatres.<BR><B>RESULTS: </B>The average corrected gestational age at surgery, associated co-morbidities, average volume of blood loss and duration of surgery were compared between the groups. Group A had lower weight at surgery (1098 vs 1872 gs), greater percentage of neonates on inotropic support (78% vs 20%) with requirement of High Frequency Ventilation (HFO) (50% vs none). A quarter of neonates (7 of 28) in Group A had NEC Totalis as against only one case in group B. There was 25% survival in group A and 76.67% in group B. The lower survival in group A can be attributed to lower weight at surgery, higher inotrope requirement and need for unconventional modes of ventilation.<BR><B>CONCLUSIONS: </B>Bedside laparotomy is a feasible option in unstable neonates deemed unsuitable for transport.