Shen Y, Lin Y, Fang YF, Wu DM, He YB. Efficacy of peritoneal drainage in very-low-birth-weight neonates with Bell’s stage II necrotizing enterocolitis: A single-center retrospective study. World J Gastrointest Surg 2023; 15(7): 1416-1422 [PMID: 37555126 DOI: 10.4240/wjgs.v15.i7.1416]
Corresponding Author of This Article
Yuan-Bin He, MM, Doctor, Department of Pediatric Surgery, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 966 Hengyu Road, Jinan District, Fuzhou 350000, Fujian Province, China. heyb1989@fjmu.edu.cn
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Jul 27, 2023; 15(7): 1416-1422 Published online Jul 27, 2023. doi: 10.4240/wjgs.v15.i7.1416
Efficacy of peritoneal drainage in very-low-birth-weight neonates with Bell’s stage II necrotizing enterocolitis: A single-center retrospective study
Yong Shen, Yu Lin, Yi-Fan Fang, Dian-Ming Wu, Yuan-Bin He
Yong Shen, Yu Lin, Yi-Fan Fang, Dian-Ming Wu, Yuan-Bin He, Department of Pediatric Surgery, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, Fuzhou 350000, Fujian Province, China
Author contributions: Shen Y and Lin Y contributed equally to this work and are co-first authors; Shen Y and Lin Y designed the research study; Shen Y, Lin Y, Fang YF and Wu DM contributed reagents and analytic tools; Shen Y, Lin Y and He YB analyzed the data; Shen Y and Lin Y wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: The study was conducted according to the guidelines of the Declaration of Helsinki and was approved by the Medical Ethics Committee of Fujian Children’s Hospital (registration number: 2022ETKLR08021).
Informed consent statement: This is a retrospective study, and since the analysis used anonymous clinical data approved by the Ethics Committee of Fujian Children’s Hospital, the need for informed consent from subjects or guardians was waived.
Conflict-of-interest statement: The authors declare no competing interests.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Yuan-Bin He, MM, Doctor, Department of Pediatric Surgery, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), College of Clinical Medicine for Obstetrics and Gynecology and Pediatrics, Fujian Medical University, No. 966 Hengyu Road, Jinan District, Fuzhou 350000, Fujian Province, China. heyb1989@fjmu.edu.cn
Received: March 22, 2023 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 Processing time: 121 Days and 4.1 Hours
ARTICLE HIGHLIGHTS
Research background
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.
Research motivation
To find an effective treatment scheme with clinical promotion and application value for VLBW newborns with modified Bell’s stage II NEC.
Research objectives
To investigate the clinical efficacy of peritoneal drainage in the treatment of VLBW newborns with modified Bell’s stage II NEC.
Research methods
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.
Research results
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.
Research conclusions
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.
Research perspectives
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.
