Necrotizing enterocolitis in very-low-birth-weight infants

Is mortality rate influenced by the site of involvement in neonates undergoing laparotomy for necrotizing enterocolitis?

“…Their disease was severe and all died. The same situation has been previously reported by Fasching et al [22]. Further prospective studies are needed to evaluate whether the involvement of the rectum may also be considered a marker of disease extent and severity.…”

“…It has been suggested that involvement of the small bowel has a higher mortality rate than involvement of the colon or the ileocecal region [22,23,[25][26][27][28], a notion that is supported by our clinical experience. However, previous investigators have not performed multivariate analyses to compare different sites of involvement.…”

“…Fasching et al [22] studied a series of patients and found a higher mortality rate when the small bowel was involved (57%; 07/12). No patients died when only the colon was affected (n = 8).…”

“…Several prognostic factors have been associated with poor outcome in NEC, such as birth weight less than 1000 g [11,12], low gestational age [13,14], small for gestational age [15,16], disease-associated complications [15,17], presence of portal venous gas [9,18,19], need for surgical treatment [20,21], small bowel involvement [22,23], and diffuse bowel involvement [1,24].…”

Surgical strategies in very‐low‐birthweight neonates with necrotizing enterocolitis

“…Resection of all necrotic and perforated bowel with decompression by exteriorization of the viable ends with preservation of as much intestinal length as possible and subsequent staged reanastomosis have been the principles of surgery by many authors (6,9,12,16).…”