Surgical Therapy for Necrotizing Enterocolitis

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Abstract
Infants (51) were treated surgically for necrotizing enterocolitis utilizing a uniform protocol from July 1980-July 1983. The surgical indications were pneumoperitoneum or a paracentesis indicative of bowel infarction. Segmental intestinal resection and bowel end exteriorization through the upper abdominal transverse incision was the usual procedure. Intestinal continuity was reestablished when the patient reached 10 lb, or sooner if he was failing to thrive with his ileostomy. Overall survival was 72.5% and it was 82% for those patients having a definitve surgical procedure. This survival rate was not adversely affected by the patient''s weight or age at operation time, nor by bowel perforation. The 37 survivors endured multiple postoperative complications. The most significant long-term sequela was shortgut syndrome, which occurred in 11% of the survivors.