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Purpose <p>To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).</p> Methods <p>Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15&#xa0;years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the “Old” group (O, n = 56; treated before March 2018) and the “New” group (N, n = 35; treated after April 2018).</p> Results <p>The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.</p> Conclusions <p>Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.</p>

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Aggressive enema and surgery for meconium-related ileus in extremely low-birth-weight infants

  • 期刊论文

  • 发表日期：

    2025年8月17日

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  • Kenji Santo,
  • Yuichi Takama,
  • Marie Todo,
  • Hisashi Yagi,
  • Shuto Ikeda,
  • Yuko Tanaka,
  • Hiroyuki Ichiba,
  • Masafumi Kamiyama

摘要

Purpose

To investigate the effectiveness of an aggressive treatment strategy for meconium-related ileus (MRI) in extremely low birth weight infants (ELBWIs).

Methods

Since April 2018, we have implemented a novel protocol, incorporating early Gastrografin injection, aggressive enema therapy, and early surgery without perforation (ES). Among 362 ELBWIs treated at our institute over the past 15 years, 91 with MRI were included in this study. We compared patient demographics, treatment details, and outcomes between the “Old” group (O, n = 56; treated before March 2018) and the “New” group (N, n = 35; treated after April 2018).

Results

The O group showed higher perforation rates (21.4%; 12/56) than those of the N group (2.9%, 1/35) (p = 0.014). The surgical rates were 21.4% (12/56) and 14.3% (5/35) in the O and N groups, respectively (p = 0.581), while the ES rates were 0% (0/56) and 11.8% (4/35), respectively (p = 0.02). The N group had a significantly higher overall survival rate (100%, 35/35) than the O group (87.5%, 49/56) (p = 0.041). In the O group, all seven deaths were related to perforation.

Conclusions

Our aggressive MRI treatment was associated with reduced perforation rates and improved survival outcomes, demonstrating its effectiveness.