Current Surgical Roles in Necrotizing Enterocolitis

• Published in: Journal of Health Science and Medical Research (JHSMR)
• Main Authors: Anuwat Palanusont, Surasak Sangkhathat
• Format: Article
• Language: English
• Published: Prince of Songkla University 2015-10-01
• Subjects: necrotizing enterocolitis; surgical treatment
• Online Access: https://www.jhsmr.org/index.php/jhsmr/article/view/193

Necrotizing enterocolitis (NEC) has an incidence around 1-3 per 1,000 live birth in low birth weight infants. The condition is a major cause of death and longterm morbidity in premature infants. Main risk factors of NEC consist of prematurity and perinatal instability of hemodynamics that leads to ischemia-reperfusion associated inflammation, bacterial translocation and systemic septicemia. In a majority of cases, treatment can be achieved by non-operative management including bowel rest, antibiotics and hemodynamic support. Surgery has its role in NEC that is not responded to such conservative management. Currently, there are 2 standard procedures, primary laparotomy and primary peritoneal drainage. Randomized trials demonstrated no difference in surgical outcome between the two principles. In cases that laparotomy is chosen, removal of pathologic bowel and creation of enterostomy is performed in most cases. However, there is no superior surgical choice in those with pan-intestinal NEC. Breast feeding, standard feeding regimen and probiotics are likely to reduce the incidence of NEC.