title: Primary anastomosis for meconium peritonitis: first choice of treatment.
abstract: OBJECTIVE
  Newborn surgery for meconium peritonitis (MP) is sometimes very difficult owing to severe adhesions and bleeding. The aim of this study was to reveal the benefit of primary anastomosis (PA) for MP by comparing PA with multistep operations (MO).
  
  
  METHODS
  We retrospectively reviewed 38 patients with MP who underwent surgery in our institution from 1983 to 2009. From 1983 to 2000, we essentially used MO. After 2001, we used PA with the exception of 1 patient. We performed MO on 20 patients (group A) and PA on 18 patients (group B).
  
  
  RESULTS
  Mortality was 4 in 20 in group A and 1 in 18 in group B. Three patients in group A and 2 in group B required reoperation because of complications. After 2001, 14 of 16 patients underwent PA. Of the 2 patients for whom PA could not be performed, one was postresuscitation from cardiopulmonary arrest and the other was an extremely low-birth-weight infant. The only mortality among the patients who underwent PA occurred in a very low-birth-weight infant who died from intraoperative hepatic hemorrhage.
  
  
  CONCLUSIONS
  PA can be performed for almost all patients with MP except for extremely low-birth-weight infants.
authors.affiliation: Department of Pediatric Surgery, Shizuoka Children's Hospital, Aoi-ku, Shizuoka, Japan. herohero6tti@gmail.com
authors.forename: Hiromu
authors.initials: H
authors.lastname: Miyake
authors.forename: Naoto
authors.initials: N
authors.lastname: Urushihara
authors.forename: Koji
authors.initials: K
authors.lastname: Fukumoto
authors.forename: Akihide
authors.initials: A
authors.lastname: Sugiyama
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Fukuzawa
authors.forename: Kentaro
authors.initials: K
authors.lastname: Watanabe
authors.forename: Maki
authors.initials: M
authors.lastname: Mitsunaga
authors.forename: Junichi
authors.initials: J
authors.lastname: Kusafuka
authors.forename: Shiro
authors.initials: S
authors.lastname: Hasegawa
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000075202:Contraindications; D003560:Cysts / Q000151:congenital / Q000209:etiology; D019468:Disease Management; D004322:Drainage; D006801:Humans; D007081:Ileostomy; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000196:embryology / Q000209:etiology / Q000601:surgery*; D019102:Infant, Very Low Birth Weight; D007409:Intestinal Atresia / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology; D007416:Intestinal Perforation / Q000150:complications / Q000000981:diagnostic imaging / Q000196:embryology*; D045822:Intestinal Volvulus / Q000150:complications / Q000196:embryology; D007443:Intussusception / Q000150:complications / Q000196:embryology; D007582:Jejunostomy; D008470:Meconium; D010538:Peritonitis / Q000151:congenital* / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal