Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1416
Peer-review started: March 22, 2023
First decision: April 10, 2023
Revised: May 2, 2023
Accepted: May 12, 2023
Article in press: May 12, 2023
Published online: July 27, 2023
For very-low-birth-weight (VLBW) neonates with modified Bell’s stage II necrotizing enterocolitis (NEC), the controversy over the choice of treatment (conservative or surgical) is also a challenge for pediatric surgeons.
To find an effective treatment scheme with clinical promotion and application value for VLBW newborns with modified Bell’s stage II NEC.
To investigate the clinical efficacy of peritoneal drainage in the treatment of VLBW newborns with modified Bell’s stage II NEC.
A total of 102 VLBW newborns with modified Bell’s stage II NEC were included, including 24 in the peritoneal drainage group, 36 in the exploratory laparotomy group, and 42 in the conservative treatment group. The efficacy of the three groups was comparatively analyzed.
Compared with conservative treatment, the time of fasting, abdominal distension relief, negative conversion of fecal occult blood (OB) and hospital length of stay (HLOS) of peritoneal drainage were significantly shorter. Although peritoneal drainage showed some advantages over conservative treatment in the rates of cure and conversion to laparotomy, as well as the incidences of intestinal perforation, intestinal stenosis and abdominal abscess, the advantages were not significant. Taking exploratory laparotomy as the control, the time of fecal OB negative conversion in the peritoneal drainage group was statistically shortened. In addition, laparotomy exploration and peritoneal drainage were not statistically different in fasting time, abdominal distension relief time, HLOS, and complication rate.
Peritoneal drainage is a simple-to-operate procedure that can improve the clinical symptoms of VLBW newborns with modified Bell’s stage II NEC and reduce HLOS, which is worthy of clinical generalization.
Peritoneal drainage is relatively simpler and easier to use in economically underdeveloped areas. In addition, it reduces the impact of surgery and anesthesia on children, and is superior to direct laparotomy in terms of long-term prognostic benefits, with high clinical application value. However, as a single-centered retrospective clinical analysis with a relatively small number of cases, this study may still have certain limitations.