Cirugía mínimamente invasiva en recién nacidos de &lt; 2.500 g

Guelfand, Miguel; M, Marcela Santos; P, Maricarmen Olivos; Larraín, Isidora García

doi:10.4067/s0370-41062014000100008

Cited by 3 publications

(3 citation statements)

References 4 publications

(11 reference statements)

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“…The preponderance of male sex among neonatal surgical patients is consistent with reported higher rates in male infants of birth defects such as intestinal atresias and hypertrophic pyloric stenosis, the latter with neonatal sex ratio of 4:1. [22,[28][29][30][31][32][33][34] Other authors have observed neonatal mortality inversely proportional to gestational age, [12,[35][36][37] which is consistent with our fi nding of fi vefold higher risk of death in preterm neonates. [38,39] The most important established predictor of neonatal mortality and morbidity is birth weight: Low birth weight substantially increases the likelihood of illnesses and complications in children aged less than one year.…”

Section: Original Researchsupporting

confidence: 88%

“…Fewer and fewer neonatal surgical indications require immediate treatment. [28,29] Our study found the lowest case fatality among those operated on days 11-30. Higher case fatality at earlier ages could partly refl ect more serious conditions becoming apparent earlier.…”

Section: Original Researchmentioning

confidence: 60%

“…The greater frequency of digestive system congenital malformations (especially anorectal malformations and esophageal atresia) in our study is consistent with fi ndings by other authors in Cuba and elsewhere. [28,33,42,43] Esophageal atresia is a common birth defect globally, occurring in 1 of every 3000 births; 50% of patients have other associated malformations. [34,44] It is considered a surgical emergency, since it is lethal if not corrected.…”

Section: Original Researchmentioning

confidence: 99%

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Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

2017

MEDICC Review

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INTRODUCTION Newborns in need of surgery are a challenge to manage and require highly specialized centers with multidisciplinary surgical teams. Since the 1980s, neonatal surgical survival has increased by up to 70% in some countries, mainly due to advances in neonatal intensive care, anesthesia and surgical technique. OBJECTIVE Describe surgical case fatality and survival in a neonatal reference hospital in Cuba, estimate risk of death, and identify potential risk predictors among neonatal characteristics.METHODS A retrospective cohort study was conducted based on hospital administrative data and clinical records for a series of surgical cases in the neonatal intensive care unit of Havana's William Soler University Children's Hospital from January 2005 to December 2015. All neonates who underwent surgery during the study period were included. The dependent variable was discharge status (alive, deceased); independent variables were: sex, age (in days) at time of surgery, gestational age, birth weight, indication for surgery, surgical order (fi rst, repeat), and presence of sepsis or other postoperative complications. The study used contingency tables to analyze associations between neonatal characteristics and discharge status. A classifi cation tree was used to obtain simple estimates of surgical risk.RESULTS Survival was 91.3% (675/739) among 739 neonates who underwent surgery. The majority were male (58.7%, 434/739), full term (84.2%, 622/739), and of normal birth weight (80.6%, 596/739). Most surgeries were performed in the fi rst 10 days of life. Digestive system anomalies constituted the most common surgical indication (57.6%, 426/739); among these anorectal malformations (26.8%, 114/426) and esophageal atresia (17.4%, 74/426) predominated. Survival rates were lower for digestive perforation (57.7%, 15/26), gastroschisis (57.1%, 4/7) and intestinal atresia (73%, 27/37). Neonates in the youngest and oldest age groups at time of surgery faced highest risk of death, especially those in the older group. Term infants with normal birth weight operated on for the fi rst time had survival rates >95%.CONCLUSIONS Survival was high and low birth weight conferred the worst prognosis. Infants with normal birth weight operated on for the fi rst time had the greatest probability of survival.

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Section: Original Researchsupporting

confidence: 88%

Section: Original Researchmentioning

confidence: 60%

Section: Original Researchmentioning

confidence: 99%

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Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

2017

MEDICC Review

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Hypertrophic pyloric stenosis in a preterm infant: a case report

Islas-Domínguez

Jiménez-Jiménez

Cruz-Díaz

et al. 2018

Revista Médica del Hospital General de México

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Experience of minimally invasive surgery in neonates with congenital malformations in a tertiary care pediatric hospital

García¹,

Licona-Islas

López-García

et al. 2020

J Indian Assoc Pediatr Surg

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Aim: The aim of this study is to report the experience with minimally invasive surgery (MIS) in neonates with congenital malformations in a tertiary care pediatric hospital. Materials and Methods: Design: descriptive study. All neonates undergoing MIS from 2013 to 2018 were included in the study. Perinatal data, characteristics of surgery, type and duration of analgesia, postoperative mechanical ventilation duration, postoperative hospitalization, and postoperative morbidity and mortality surgery-related rates were recorded. Results: Seventy-one neonates were included. Gestational age and weight at surgery ranged from 24 to 41 weeks and from 1350 g to 4830 g, respectively. Procedures performed were esophageal atresia/tracheoesophageal fistula repair, congenital diaphragmatic hernia repair, diaphragmatic plication, fundoplication/gastrostomy, intestinal atresia repair, and pancreatectomy. The median follow-up period was 14 months. Five neonates (7%) were converted to open, for surgical difficulties. Nine (12.6%) neonates had intraoperative complications, with decreased oxygen saturation as the most common complication. The median duration of analgesia and postoperative mechanical ventilation was 3 days in most procedures. The morbidity and mortality rates were 36.6% and 2.8%, respectively. Conclusions: In this first experience with MIS in neonates, the duration of analgesia and hospitalization was shorter for some procedures. However, intraoperative and postoperative complications were still high, which was possibly attributed to the learning curve. Thus, it is expected that the frequency of the complications presented in this study will be reduced in future.

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Cirugía mínimamente invasiva en recién nacidos de < 2.500 g

Cited by 3 publications

References 4 publications

Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

Neonatal Surgery Case Fatality and Associated Factors in a Cuban Pediatric Hospital, 2005–2015

Hypertrophic pyloric stenosis in a preterm infant: a case report

Experience of minimally invasive surgery in neonates with congenital malformations in a tertiary care pediatric hospital

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