caa a22 4500 46577248X CHVBK 20180323111932.0 cr unu---uuuuu 170327e19900801xx s 000 0 eng 10.1007/BF00177105 doi (NATIONALLICENCE)springer-10.1007/BF00177105 Surgical outcome of necrotizing enterocolitis [Elektronische Daten] [Nitsana Spigland, Salam Yazbeck, Jean Desjardins] Forty-six neonates were treated for necrotizing enterocolitis (NEC) between 1982 and 1987. The mean gestational age was 33.6 weeks and the mean birth weight was 1865 g. Birth weight less than 1500 g and gestational age less than 32 weeks had an adverse effect on survival. Neonates less than or equal to 30 week's gestation developed symptoms at a mean age of 10.8 days while those greater than 30 weeks developed symptoms at a mean age of 1.7 days. All infants who never had enteral feedings survived; 20 were cured with medical treatment only. Three patients underwent peritoneal lavage (2 of these survived). Twenty-two patients required surgery; the operative mortality was 9%. Four patients underwent elective surgery for primary strictures. The remaining 18 presented with acute perforation (11), obstruction (5), deterioration with medical therapy (1), or peritonitis (1). The most frequent site of perforation was the terminal ileum, while the most common site of stricture was the left colon. Seven patients were found to have strictures after prior emergency surgery. In 6 of the patients who underwent primary enterostomy, the strictures were located in the defunctionalized bowel segment. Evidence of progression of the disease, which most frequently involved the right and transverse colon, necessitated extensive resection. When performing a proximal ileostomy for acute NEC, the surgeon must be aware that the chances of conservation of the defunctionalized distal bowel segment are minimal because of progression of the disease. Complications related to resection of the ileocecal valve have been negligible. Our results with peritoneal lavage are encouraging, and our overall mortality of 13% in contrast with higher rates in earlier series reflects improvement in the management of these neonates. Springer-Verlag, 1990 Necrotizing enterocolitis nationallicence Spigland Nitsana Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut Yazbeck Salam Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut Desjardins Jean Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut Pediatric Surgery International Springer-Verlag 5/5(1990-08-01), 355-358 0179-0358 5:5<355 1990 5 383 https://doi.org/10.1007/BF00177105 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF00177105 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Spigland Nitsana Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut NATIONALLICENCE 700 1- Yazbeck Salam Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut NATIONALLICENCE 700 1- Desjardins Jean Department of Surgery, Hôpital Sainte-Justine, University of Montreal, 3175 Ste-Catherine Road, H3T 1C5, Montreal, Quebec, Canada aut NATIONALLICENCE 773 0- Pediatric Surgery International Springer-Verlag 5/5(1990-08-01), 355-358 0179-0358 5:5<355 1990 5 383 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer