Features of the diagnostics and surgical treatment of necrotizing enterocolitis

Introduction. Necrotizing enterocolitis (NEC) is one of the common causes for abdominal surgery in newborns and infants over he first months of life with a high mortality rate (23.5%), increased in case of surgery to 67%.

Materials and methods. We compared premature (n = 25) and full-term (n = 22) newborns operated for NEC complications (laparotomy, resection of necrotized sections of the intestine, intestinal stoma). Also, we evaluated the results of treatment of infants with intestinal stoma after surgical NEC (n = 110, groups 1, 2 and 3).

Results. Full-term cases with congenital heart defects are at risk of surgical NEC (p < 0.05). Subtotal and total forms of NEC are associated with lethal outcomes up to 100% in both premature and full-term infants. It is necessary to preserve the ileocecal angle; length measuring of the remaining intestine along the mesenteric edge helps to predict further risks: 60 cm and less leads to 80–100% of post-resection short bowel syndrome.

Conclusion. NEC in full-term newborns is due to its hypoxic nature and impaired mesenteric perfusion (congenital heart defects). Surgical NEC can occur without typical symptoms (“covered perforation”), the discrepancy between the clinical and radiographic picture may indicate to subtotal or total intestinal necrosis with up to 100% of lethal outcomes.

Contribution:
Gurskaya A.S., Zorkin S.N., Dyakonova E.Yu. — research concept and design of the study;
Nakovkin O.N., Sulavko M.A., Karnuta I.V., Klepikova A.A., Piloyan F.S., Akhmedova D.M. — data collection and processing;
Bayazitov R.R. — statistical processing of the data;
Gurskaya A.S. — writing the text;
Ekimovskaya E.V. — editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: September 12, 2024
Accepted: October 08, 2024
Published: November 12, 2024

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