title: Influence of surgical intervention on neurodevelopmental outcome in infants with focal intestinal perforation.
abstract: BACKGROUND
  Intestinal perforation is known to correlate with neurodevelopmental outcome in very low-birthweight (VLBW) infants, and its two major causes are necrotizing enterocolitis (NEC) and focal intestinal perforation (FIP). Infants with FIP are reported to have better neurodevelopmental outcome than infants with NEC, but outcome has not been compared with that in infants without diseases that require surgery. The aim of this study was to compare neurodevelopmental outcomes between FIP survivors and infants without diseases that require surgery.
  
  
  METHODS
  Records of VLBW infants with FIP and infants without surgical diseases were retrospectively analyzed. Neurodevelopmental outcome was compared between eight infants with FIP and 24 case-matched control infants without surgical diseases using the Kyoto Scale of Psychological Development. Control group members were individually matched with FIP survivors for sex, gestational age, birthweight, and intraventricular hemorrhage (IVH) grade. Those with an episode of sepsis or severe IVH (grade 3-4) that occurred irrespective of FIP were excluded.
  
  
  RESULTS
  Three FIP survivors and 12 infants without surgical diseases were classified as neurodevelopmentally normal (37.5% vs 50%, P = 0.69) at a corrected age of 18 months-3 years. All neurodevelopmentally normal FIP survivors were born at a gestational age ≥ 26 weeks.
  
  
  CONCLUSIONS
  Excluding the influence of sepsis or severe IVH, no significant difference was found in neurodevelopmental outcome between FIP survivors and infants without surgical diseases. None of the FIP infants born before 26 weeks of gestation, however, had normal neurodevelopment, suggesting that longer gestation might be needed to overcome the stress associated with FIP.
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
authors: Yujiro
authors: Y
authors: Tanaka
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.|Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors: Hiroo
authors: H
authors: Uchida
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
authors: Hiroshi
authors: H
authors: Kawashima
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.|Department of Pediatric Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors: Kaori
authors: K
authors: Sato
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.|Department of Pediatric Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors: Shinya
authors: S
authors: Takazawa
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.|Department of Pediatric Surgery, University of Tokyo Hospital, Tokyo, Japan.
authors: Kyoichi
authors: K
authors: Deie
authors: Department of Pediatric Surgery, Saitama Children's Medical Center, Saitama, Japan.
authors: Takayuki
authors: T
authors: Masuko
authors: Department of Neonatology, Saitama Children's Medical Center, Saitama, Japan.
authors: Keiichi
authors: K
authors: Kanno
authors: Department of Neonatology, Saitama Children's Medical Center, Saitama, Japan.
authors: Masaki
authors: M
authors: Shimizu
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology / Q000209:etiology*; D020345:Enterocolitis, Necrotizing / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology*; D019102:Infant, Very Low Birth Weight; D007416:Intestinal Perforation / Q000150:complications / Q000601:surgery*; D007564:Japan / Q000453:epidemiology; D008297:Male; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
keywords: intestinal perforation; intraventricular hemorrhage; neurodevelopment; surgery; very low-birthweight infant