1. Surgical Necrotizing Enterocolitis – Can We Predict the Need for Gastrostomy Tube Placement?
- Author
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Vaughn, Alyssa E., Lyttle, Bailey D., Tran, Wesley, Derderian, S. Christopher, Liechty, Kenneth W., and Gien, Jason
- Subjects
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GASTROSTOMY , *ENTEROCOLITIS , *OSTOMY , *PREMATURE infants , *LENGTH of stay in hospitals , *BRONCHOPULMONARY dysplasia - Abstract
Necrotizing enterocolitis (NEC) is a significant cause of morbidity and mortality among extremely premature infants. Approximately 50% of cases progress to surgery, frequently resulting in resection of necrotic bowel and ostomy creation. Premature neonates are at risk for bronchopulmonary dysplasia and feeding failure; surgery in these patients is higher risk. We evaluated the incidence of gastrostomy tube (GT) placement after ostomy reversal in surgical NEC to define a subset of patients who would benefit from concurrent ostomy reversal and GT placement. A single-center retrospective study of infants with surgical NEC requiring ostomy creation between 2007 and 2021 was performed. Eighty patients met inclusion criteria. A GT was placed in 45/80 (56.3%), of which 3/45 (6.7%) were placed before, 20/45 (44.4%) concurrently with, and 22/45 (48.9%) after ostomy reversal. Between those who did and did not require GT placement, there were no significant differences in gestational age (27 versus 27 wk, P = 0.94) or birth weight (830 g versus 1055 g, P = 0.36). Hospital length of stay was longer in the GT group (128.2 versus 70.9 d, P < 0.0001). Time from ostomy reversal to hospital discharge was shorter when performed concurrently with GT (56 v er s us 77 d, P = 0.02). There were no differences in short-term or long-term GT related complications based on timing of GT placement. GT placement occurred in approximately 50% of patients with surgical NEC and GT may be accomplished safely at the time of ostomy reversal thus reducing the need for an additional procedure. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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