Abstract:
UNLABELLED:Necrotizing enterocolitis (NEC) is a serious condition with a high morbidity and mortality commonly affecting premature babies. Data for the impact of the long-term disease burden in developing countries are limited although poor long-term outcome of surgically managed patients has been shown in terms of increased risk of neurodevelopmental delay, increased infectious disease burden and abnormal neurological outcomes in the developed world. PURPOSE:To evaluate the long-term outcome of a pre-human immunodeficiency virus pandemic NEC cohort to characterize common risk factors and outcome in a developing world setting. METHODS:A retrospective review of medical records was carried out on a cohort of 128 premature neonates with surgical NEC (1992-1995). Morbidity, mortality and long-term outcome were evaluated. RESULTS:Data for 119 of 128 sequentially managed neonates with surgically treated NEC was available. Mean gestational age was 32 weeks and average birth weight was 1,413 g. Early (30-day postoperative) survival was 69% (n = 82) overall and 71% in the <1,500 g birth weight group (n = 68; 53%). Overwhelming sepsis (n = 16) or pan-intestinal necrosis (n = 18) accounted for most of the early deaths. Late deaths (>30 days postoperatively, n = 22) resulted from short bowel syndrome (5), sepsis (9), intraventricular hemorrhage (1) and undetermined causes (7). On follow-up (mean follow-up 39 months, 30 for >2 years), long-term mortality increased to 50%. Late surgical complications included late colonic strictures (9), incisional hernias (2) and adhesive bowel obstruction (3). Fifteen patients had short bowel syndrome, of which 10 (66%) survived. Of the long-term survivors, 8 (20%) had severe neurological deficits and 20 (49%) had significant neurodevelopmental delay. Neurological deficits included severe auditory impairment [5 (12%)] and visual impairment [4 (10%)]. Recurrent infections and gastrointestinal tract complaints requiring hospital admission occurred in 16 (39%) of survivors. CONCLUSION:Necrotizing enterocolitis in premature infants impacts morbidity and mortality considerably. A number do well in a developing country, but septic complications may be ongoing and recurrent. The high risk of neurodevelopmental and other problems continue beyond the neonatal period and patients should be "flagged" on for careful follow-up.
journal_name
Pediatr Surg Intjournal_title
Pediatric surgery internationalauthors
Arnold M,Moore SW,Sidler D,Kirsten GFdoi
10.1007/s00383-010-2583-8subject
Has Abstractpub_date
2010-04-01 00:00:00pages
355-60issue
4eissn
0179-0358issn
1437-9813journal_volume
26pub_type
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journal_title:Pediatric surgery international
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doi:10.1007/s00383-006-1837-y
更新日期:2007-02-01 00:00:00
abstract:INTRODUCTION:Recent advances in laparoscopic surgery as well as increasing experience with these techniques have led to the selection of laparoscopic surgery for hemi/partial nephroureterectomy in children with a non/poorly functioning moiety in a duplex kidney. There is very little data on the long term follow-up of s...
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journal_title:Pediatric surgery international
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doi:10.1007/s00383-013-3398-1
更新日期:2013-12-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract:PURPOSE:Radiologically inserted gastrojejunal tubes (RGJ) and surgical jejunostomy (SJ) are established modes of jejunal feeding. The aim of the study is to review nutritional outcomes, complications and the practical consideration to enable patients and carers to make informed choice. METHODS:Retrospective review of ...
journal_title:Pediatric surgery international
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doi:10.1007/s00383-018-4303-8
更新日期:2018-09-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-009-2480-1
更新日期:2010-02-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2264-z
更新日期:2008-12-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-017-4062-y
更新日期:2017-06-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-009-2356-4
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doi:10.1007/s00383-008-2138-4
更新日期:2008-06-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/BF01076950
更新日期:1997-07-01 00:00:00
abstract::Congenital mesoblastic nephroma (CMN) is a rare paediatric renal neoplasm. It is a diagnostic challenge to the pathologists due to its close differentials having ominous prognosis. We present three cases of CMN with unusual morphology including evidence of renal dysplasia in one of them. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2279-5
更新日期:2009-01-01 00:00:00
abstract::Polyorchidism is defined as the presence of more than two testes. We report the case of a 3-year-old boy and review the embryology and surgical management of the condition. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050247
更新日期:1998-01-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章,meta分析
doi:10.1007/s00383-015-3705-0
更新日期:2015-06-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050261
更新日期:1998-03-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-002-0858-4
更新日期:2002-10-01 00:00:00
abstract::Since January 2006, robotic assistance has been used for performing minimal invasive laparoscopic fundoplications in children. These patients were compared with those operated on with either the open surgical technique or the laparoscopic procedure. The first six children operated on with a fundoplication using the op...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-006-1817-2
更新日期:2007-02-01 00:00:00
abstract::Non-operative management of gastroschisis also known as plastic closure (PC) has been described as an alternative to conventional primary operative closure (POC) or staged silo closure (SSC). The aim of this study was to compare these techniques in neonates with gastroschisis. A retrospective review of neonates with g...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2153-5
更新日期:2008-07-01 00:00:00
abstract:PURPOSE:The purpose of this study was to review the clinical characteristics and prognosis of children with adrenocortical tumors (ACT). METHODS:We retrospectively reviewed the medical records of 28 patients with ACT at our hospital between March 2010 and March 2017. RESULTS:The main clinical presentations were sexua...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-018-4409-z
更新日期:2019-03-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830050281
更新日期:1998-03-01 00:00:00
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doi:10.1007/s00383-019-04525-x
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更新日期:2000-01-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章,meta分析,评审
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更新日期:2016-12-01 00:00:00
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更新日期:2018-05-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-013-3314-8
更新日期:2013-06-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s003830000506
更新日期:2001-03-01 00:00:00
abstract::Gastroschisis closure is performed either primarily or after staged reduction of the prolapsed bowel. A technique for surgical closure of the abdominal wall defect is described which allows for an almost scarless appearance of the abdominal surface with preservation of a midline umbilicus. ...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-008-2215-8
更新日期:2008-09-01 00:00:00
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journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-010-2707-1
更新日期:2010-12-01 00:00:00
abstract::Pulmonary sequestrations are non-functional masses of lung tissue lacking normal communication with the tracheobronchial tree and systemic-circulation-derived blood supply. The disconnection between the normal airway and pulmonary arterial supply prevents pulmonary sequestrations from participating in respiration whil...
journal_title:Pediatric surgery international
pub_type: 杂志文章
doi:10.1007/s00383-017-4072-9
更新日期:2017-07-01 00:00:00
abstract:PURPOSE:Tracheoesophageal fistula (TEF) is a bellwether for a country's ability to care for sick newborns. We aim to review the existing literature from low- and middle-income countries in regard to management of those newborns and the possible approaches to improve their outcomes. METHODS:A review of the existing Eng...
journal_title:Pediatric surgery international
pub_type: 杂志文章,评审
doi:10.1007/s00383-020-04639-7
更新日期:2020-05-01 00:00:00