Abdominal pathology requiring laparotomy in very preterm infants is associated with need for surgical closure of patent ductus arteriosus.
BACKGROUND
Extensive intestinal surgery in very preterm infants and its influence on somatic growth is of major concern. There is little consensus as to which is the most appropriate surgical approach in extremely low-birth-weight infants with abdominal pathology. Laparotomy is currently advocated, but peritoneal drainage is also discussed.


OBJECTIVE
To study laparotomy as surgical intervention in newborn infants with less than 28 gestational weeks and to investigate associated mortality and morbidity and its impact on short-term growth.


METHODS
The study was a retrospective case-control study of newborn infants requiring laparotomy. All infants with gestational age less than 28 weeks who were subject to acute laparotomy in the neonatal period at Sahlgrenska University Hospital during a 5-year period (2003-2007) were included in the study (n = 20). The control group consisted of infants admitted to the unit with the same gestational age but not requiring laparotomy. Infants with severe malformations were excluded.


CONCLUSIONS
Extensive abdominal surgery was feasible in very preterm infants. Necrotizing enterocolitis dominated the abdominal pathology requiring surgery. Patent ductus arteriosus requiring surgical closure occurred more often in the lapatotomy group and in those diagnosed as necrotizing enterocolitis. There was no impact on first year somatic growth.
Division of Neonatology, Department of Pediatrics, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden.
Sara
S
Röjås
Helena
H
Borg
Mats
M
Edenholm
Kenneth
K
Sandberg
Anders
A
Elfvin
D016022:Case-Control Studies; D015897:Comorbidity; D004374:Ductus Arteriosus, Patent / Q000453:epidemiology / Q000601:surgery*; D020345:Enterocolitis, Necrotizing / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D005865:Gestational Age; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000601:surgery*; D007813:Laparotomy; D008026:Ligation; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis