[Peritoneal drainage as an alternative to laparotomy in premature infants with complicated necrotizing enterocolitis].
The highest mortality due to necrotizing enterocolitis (NEC) in noted among low birth weight infants. Poor general medical condition of those children does not allow for major surgery despite obvious symptoms of perforation that usually require laparotomy. The aim of this study was assessment of the outcome of peritoneal drainage in complicated NEC in low birth weight infants.


METHODS
Peritoneal drainage was employed in the treatment of fifteen children with perforated NEC between 1995 and 2002. Mean gestational age of studied newborns was 28.2 weeks, mean birth weight 1178 g (670-2540 g).


RESULTS
Eight children survived. Their mean gestational age was 26.8 weeks, mean birth weight--876 g. Seven children died 1-15 days after the perforation. Their mean gestational age was 29.9 weeks, mean birth weight 1227 g.


CONCLUSIONS
Survival of low birth weight infants with perforated NEC treated by the peritoneal drainage was 53.3%. The result doesn't seem to be very good unless we remember that before introduction of peritoneal drainage those children would probably die during surgery. Taking in account positive opinions about this method we may conclude that the use of peritoneal drainage could be extended to more patients with complications of NEC and should not be reserved for "hopeless" cases only.
Bysiek
Adam
A
Klinika Chirurgii Dzieciecej Katedry Chirurgii Pediatrycznej, Polsko-Amerykańskiego Instytutu Pediatrii Wydziału Lekarskiego Uniwersytetu Jagiellońskiego, 30-663 Kraków, ul. Wielicka 265.
Palka
Joanna
J
Pietrzyk
Jacek J
JJ
Mitkowska
Zofia
Z
Tomasik
Tomasz
T
D004322:Drainage / Q000379:methods*; D020345:Enterocolitis, Necrotizing / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000150:complications; D007813:Laparotomy / Q000379:methods*; D010529:Peritoneal Cavity; D015996:Survival Rate