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http://dx.doi.org/10.3345/kjp.2009.52.3.295

Gastrointestinal surgery in very low birth weight infants: Clinical characteristics  

Kim, Ji Eun (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Yoo, Hye Soo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Kim, Hea Eun (Division of Pediatric Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Soo Kyoung (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Jeong, Yoo Jin (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Choi, Seo Heui (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Seo, Hyun Joo (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Chang, Yun Sil (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Seo, Jeong Meen (Division of Pediatric Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine)
Park, Won Soon (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine)
Lee, Suk Koo (Division of Pediatric Surgery Samsung Medical Center, Sungkyunkwan University School of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.52, no.3, 2009 , pp. 295-302 More about this Journal
Abstract
Purpose : To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics. Methods : Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed. Results : The mean gestational age ($27^{+6}2^{+3}$ vs. $28^{+5}{\pm}$2^{+6}$) and birth weight (979${\pm}$241 g vs. 1,071${\pm}$271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period. Conclusion : GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.
Keywords
Infant; Very low birth weight; Infant; Extremely low birth weight; Necrotizing enterocolitis; Intestinal perforation; Laparotomy;
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