Surgical treatment for neonates with necrotising enterocolitis in the republic of Ireland: are we just seeing patients at the tip of the iceberg?
摘要
Necrotising enterocolitis (NEC) is a life-threatening gastrointestinal condition predominantly affecting preterm infants. The majority of patients with NEC are treated medically, however, approximately 25% of patients require surgical intervention.
AimsThis study wished to assess the national outcomes for patients with surgical NEC in Ireland. The data was gathered from the only two centres in Ireland that perform this type of surgery.
MethodAll patients in the Republic of Ireland who underwent a laparotomy for NEC were identified over a 10 year period (2012-2022). The following information was obtained for each patient: sex, gestational age, birth weight, medical co-morbidities, length of bowel resection in centimetres, presence/absence of ileocecal valve after surgery, stoma formation, time from maternity hospital referral to surgical procedure and mortality.
Results133 patients underwent laparotomy for NEC over the 10 year study period. 101 (75.9%) patients were alive at the time of data collection and 32 patients died, resulting in a mortality rate of 24.1%. All 13 patients with NEC totalis died (phi correlation with mortality 0.555). 0 patients with spontaneous intestinal perforation (SIP) died (phi correlation-0.152). Loss of ileocaecal valve at surgery was statistically significantly associated with mortality (phi correlation 0.536).
ConclusionThe outcomes for neonates with surgical NEC in Ireland in our study are favourable compared to the published literature. Our outcomes may be better than published data as they may not reflect a subgroup of patients with NEC in Ireland that never made it to our tertiary institutions for surgical assessment.