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Gastrointestinal surgery in very low birth weight infants : Clinical characteristics

Korean Journal of Pediatrics 2009;52(3):295-302.
Published online March 15, 2009.
Gastrointestinal surgery in very low birth weight infants : Clinical characteristics
Ji Eun Kim1, Hye Soo Yoo1, Hea Eun Kim2, Soo Kyoung Park1, Yoo Jin Jeong1, Seo Heui Choi,1, Hyun Joo Seo1, Yun Sil Chang1, Jeong Meen Seo2, Won Soon Park1, Suk Koo Lee2
1Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
2Division of Pediatric Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
극소 저체중 출생아에서 시행한 소화기계 수술의 임상적 특성
김지은1, 유혜수1, 김혜은2, 박수경1, 정유진1, 최서희1, 서현주1, 장윤실1, 서정민2, 박원순1, 이석구2
1성균관대학교 의과대학 삼성서울병원 소아과학교실
2성균관대학교 의과대학 삼성서울병원 소아외과학교실
Correspondence: 
Won Soon Park, Email: wonspark@skku.edu
Abstract
Purpose
: To report our experience of gastrointestinal (GI) operations (OP) performed in very low birth weight infants (VLBWI) and to evaluate their clinical characteristics.
Methods
: Among the 1,117 VLBWI admitted to the SMC neonatal intensive care unit from November 1994 to February 2007, the medical records of 37 infants who underwent GI OP (except inguinal hernia OP) and 1,080 VLBWI without GI OP were retrospectively reviewed.
Results
: The mean gestational age (27+62+3 vs. 28+5¡¾2+6) and birth weight (979¡¾241 g vs. 1,071¡¾271 g) of the 37 VLBWI who underwent the GI OP was lower than the VLBWI without GI OP group (n=1,080). Mortality rates in the GI OP group were significantly higher than in the non GI OP group (28% vs. 15%, P<0.001). The incidence of cholestasis, retinopathy of prematurity and periventricular leukomalacia were higher in the GI OP group than in the non GI OP group, but the incidence of bronchopulmonary dysplasia was not significantly different between the GI OP group and the non GI OP group. For GI OP indications, focal intestinal perforation was most common and showed a more favorable outcome than necrotizing enterocolitis. Compared with an earlier 7-year period, 1994-2000, the incidence and survival rates increased in the subsequent 2001-2007 period.
Conclusion
: GI OP was associated with high mortality and morbidity in VLBWI. Further efforts to improve outcomes of GI OP in VLBWI should be investigated to improve the quality of care in VLBWI.
Key Words: Infant, Very low birth weight, Infant, Extremely low birth weight, Necrotizing enterocolitis, Intestinal perforation, Laparotomy


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