title: [Role of laparoscopy in premature infants with suspicion of necrotizing enterocolitis].
abstract: BACKGROUND
  The indication of surgery in necrotizing enterocolitis (NEC) can be difficult in the absence of pneumoperitoneum or peritonitis. We propose laparoscopy for early diagnosis of intestinal perforation or necrosis in order to avoid unneccessary laparotomies.
  
  
  METHODS
  A new protocol was proposed which included diagnostic and therapeutic laparoscopy in cases of uncertain surgical ECN indication. Subsequently, a prospective study of the 7 patients who underwent laparoscopy was performed, analyzing pathophysiological effects in the premature, technical difficulties of the procedure, and postoperative diagnostic consistency.
  
  
  RESULTS
  The mean gestational age at birth was 27 weeks (range 25 to 31) with an average weight of 1.147 kg (range 0.900 to 1.600) two trocars were placed as the focal oriented scanning or radiography, using a pneumoperitoneum 6-10 mmHg for an average of 17 min. Laparoscopy avoided laparotomy in a patient who did well after washing and drainage and magnified lesions in one patient who did not require laparotomy after intestinal bypass. In other cases, laparoscopy was followed by minilaparotomy oriented to the lesions and stoma formation. There were no surgical complications attributable to the procedure, which was well tolerated in all cases.
  
  
  CONCLUSIONS
  Laparoscopy can be a useful tool for evaluation of lesions of NEC in cases of uncertain surgical indications. In our experience, it is well tolerated in neonates of low weight, allowing oriented minilaparotomies or even to avoid laparotomy.
authors.affiliation: Servicio Cirugía Pediátrica, Hospital Infantil Gregorio Marañón, Madrid. carol.corona@hotmail.com
authors.forename: C
authors.initials: C
authors.lastname: Corona Bellostas
authors.forename: A
authors.initials: A
authors.lastname: Cañizo López
authors.forename: A R
authors.initials: AR
authors.lastname: Tardáguila Calvo
authors.forename: M
authors.initials: M
authors.lastname: Zornoza Moreno
authors.forename: D
authors.initials: D
authors.lastname: Peláez Mata
authors.forename: J A
authors.initials: JA
authors.lastname: Cerdá Berrocal
authors.forename: R M
authors.initials: RM
authors.lastname: Romero Ruiz
authors.forename: A
authors.initials: A
authors.lastname: Parente Hernández
mesh_terms: D013505:Digestive System Surgical Procedures / Q000379:methods; D020345:Enterocolitis, Necrotizing / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000601:surgery*; D010535:Laparoscopy; D011446:Prospective Studies