Universität zu Köln

Duebbers, Martin, Holtkamp, Gerd, Cernaianu, Grigore, Bludau, Marc, Fischer, Janina, Keller, Titus, Kribs, Angela and Schulten, Daisy (2021). Primary anastomosis as a valid alternative for extremely low birth weight infants with spontaneous intestinal perforation. Eur. J. Pediatr., 180 (5). S. 1529 - 1536. NEW YORK: SPRINGER. ISSN 1432-1076

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Abstract

The aim was to assess the results of primary anastomosis (PA) compared to enterostomy (ES) in infants with spontaneous intestinal perforation (SIP) and a weight below 1000 g. Between 2014 and 2016, enterostomy was routinely carried out on extremely low birth weight (ELBW) patients with SIP. From 2016 until 2019, all patients underwent anastomosis without stoma formation. We compared outcome and complications in both groups. Forty-two patients with a median gestational age of 24.3 weeks and a birth weight of 640 g with SIP were included. Thirty patients underwent PA; ES was performed in 12 patients. Overall in-hospital mortality was 11.9% (PA: 13.3%, ES: 8.3%). Reoperations due to complications became necessary in 10/30 patients with PA and 4/12 patients with ES. Length of stay was 110.5 days in the PA group and 124 days in the ES group. Median weight at discharge was higher in the PA group (PA: 2258 g, ES: 1880 g, p = .036). Conclusion: Primary anastomosis is a feasible treatment option for SIP in infants < 1000 g and may have a positive impact on weight gain and length of hospitalization. However, further studies on selection criteria for PA are necessary. What is Known: center dot Enterostomy (ES) and primary anastomosis (PA) are feasible treatment options in preterm infants with spontaneous intestinal perforation (SIP). center dot Stomal complications or failure to thrive due to poor food utilization can pose significant problems. What is New: center dot Primary anastomosis in case of SIP is equal to enterostomy in terms of mortality and revision rate; however, length of stay and weight gain can be presumably positively influenced. center dot Primary anastomosis is a valid treatment option even for patients weighing less than 1000 g.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Duebbers, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Holtkamp, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Cernaianu, Grigore UNSPECIFIED UNSPECIFIED UNSPECIFIED Bludau, Marc UNSPECIFIED UNSPECIFIED UNSPECIFIED Fischer, Janina UNSPECIFIED UNSPECIFIED UNSPECIFIED Keller, Titus UNSPECIFIED UNSPECIFIED UNSPECIFIED Kribs, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulten, Daisy UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-567440
DOI:	10.1007/s00431-021-03926-2
Journal or Publication Title:	Eur. J. Pediatr.
Volume:	180
Number:	5
Page Range:	S. 1529 - 1536
Date:	2021
Publisher:	SPRINGER
Place of Publication:	NEW YORK
ISSN:	1432-1076
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language NECROTIZING ENTEROCOLITIS; PERITONEAL DRAINAGE; INTENSIVE-CARE; LAPAROTOMY; OUTCOMES; SURGERY Multiple languages Pediatrics Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56744