Mortality and intestinal failure in surgical necrotizing enterocolitis.

Overview

BACKGROUND/PURPOSE: To examine whether as initial surgical intervention for necrotizing enterocolitis, primary peritoneal drainage as compared to primary laparotomy is associated with increased mortality or intestinal failure. METHODS: Retrospective observational study of 240 infants with surgical necrotizing enterocolitis. RESULTS: There was no difference concerning the composite outcome of mortality before discharge or survival with intestinal failure after adjusting for known covariates (Odds Ratio 1.73, 95% CI 0.88, 3.40). More surviving infants in the peritoneal drainage with subsequent salvage or secondary laparotomy had intestinal failure compared to those who received a peritoneal drain without subsequent laparotomy and survived (12% vs. 14% vs. 1%, p=0.015). CONCLUSIONS: There is no difference between peritoneal drainage and laparotomy in infants with surgical necrotizing enterocolitis concerning the combined outcome of mortality or survival with intestinal failure. There is increased intestinal failure in surviving infants treated with peritoneal drain with either subsequent salvage or secondary laparotomy compared to peritoneal drainage alone.