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Outcomes of diverting jejunostomy for severe necrotizing enterocolitis.
- Source :
- Journal of Pediatric Surgery; Jun2011, Vol. 46 Issue 6, p1041-1044, 4p
- Publication Year :
- 2011
-
Abstract
- Abstract: Background/Purpose: A diverting jejunostomy without bowel resection is an option for surgical management of extensive necrotizing enterocolitis (NEC). We aimed to determine outcomes of infants who underwent this operation. Methods: We collected clinical and outcome data on infants undergoing a diverting jejunostomy with no bowel resection as a primary procedure for extensive NEC. Data are median (range). Results: Seventeen neonates underwent a diverting jejunostomy. Eleven (65%) had multifocal disease, whereas 6 (35%) had pan-intestinal involvement. Perforation was seen in 7 (41%), all with multifocal disease. The stoma was placed 12 cm (8-45) from the duodenojejunal flexure. Six infants (35%) died, 4 of these within a day of operation, owing to persisting instability. Intestinal continuity was achieved in all survivors after 52 (17-83) days, and only 1 infant (9%) had a colonic stricture. Seven infants recovered without the need for further intestinal resection distal to the jejunostomy. In those that survived, parenteral nutrition was needed for 2.2 months (1.3-18.0). A single patient had short bowel syndrome. Conclusions: A diverting jejunostomy is a useful surgical procedure that allows high survival and enteral autonomy in the treatment of extensive NEC. In most patients, the affected intestine recovers without further intestinal resection. [Copyright &y& Elsevier]
Details
- Language :
- English
- ISSN :
- 00223468
- Volume :
- 46
- Issue :
- 6
- Database :
- Supplemental Index
- Journal :
- Journal of Pediatric Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 61493537
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2011.03.024