Korean J Pediatr.  2009 Mar;52(3):295-302. 10.3345/kjp.2009.52.3.295.

Gastrointestinal surgery in very low birth weight infants: Clinical characteristics

• Kim JE
• Yoo HS
• Kim HE
• Park SK
• Jeong YJ
• Choi SH
• Seo HJ
• Chang YS
• Seo JM
• Park WS
• Lee SK

• KMID: 2281106
• DOI: http://doi.org/10.3345/kjp.2009.52.3.295

Abstract

PURPOSE
To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics.
METHODS
Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed.
RESULTS
The mean gestational age (27(+6)2(+3) vs. 28(+5)+/-2(+6)) and birth weight (979+/-241 g vs. 1,071+/-271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period.
CONCLUSION
GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.

Keyword

Infant, Very low birth weight; Infant, Extremely low birth weight; Necrotizing enterocolitis; Intestinal perforation; Laparotomy

MeSH Terms

Birth Weight
Bronchopulmonary Dysplasia
Cholestasis
Enterocolitis, Necrotizing
Gestational Age
Hernia, Inguinal
Humans
Incidence
Infant
Infant, Extremely Low Birth Weight
Infant, Newborn
Infant, Very Low Birth Weight
Intensive Care, Neonatal
Intestinal Perforation
Laparotomy
Leukomalacia, Periventricular
Medical Records
Retinopathy of Prematurity
Retrospective Studies
Survival Rate