Summary:
Aim: The aim of this study is to assess a contemporary treatment potential for necrotizing enterocolitis in
newborns with birth weights under 1000 g.
Methodology and Subjects: This is a retrospective study of clinical and pathological data in a group of 19
newborns with birth weights under 1000 g treated for necrotizing colitis (NEC) by the authors‘ team from 1999
to 2003. Only newborns with the second and third grade NEC according to Bell were included in the trial group.
Results: The trial group included 19 newborns born in the 26th gestation week, on average (ranging from 23–
to 31) with a mean birth weight of 711 grams (the range between 460–980 g). Their NEC appeared on the 18th
postnatal day, on average (the range between 6–59). Ten newborns were operated in the acute stage of their NEC,
nine were treated conservatively. Five infants operated in the acute stage had separational ileostomy conducted,
four had a T-drain introduced and one had an abdominal drain introduced. In the conservatively managed group,
three infants were consequently operated for intestinal strictures following their NEC, two recovered during the
conservative treatment and four exited due to a fast progress of their NEC without surgery. The total mortality
rate of the trial group was 42% (8 infants exited).Conclusion: TheNECtreatment in the extremely immature newborns with birth weigts under 1000 g requires
complex cooperation of a neonatologist and a paediatric surgeon. The necrotic intestine resections followed by
stomic procedures remain standard procedures in unstable newborns with a localised form of the disease.
Key words:
necrotizing enterocolitis – surgical treatment of the NEC – extremely immature newborns
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