All issues > Volume 52(3); 2009

Original Article

Korean J Pediatr. 2009;52(3):295-302. Published online March 15, 2009.

Gastrointestinal surgery in very low birth weight infants : Clinical characteristics

Ji Eun JE Kim¹, Hye Soo HS Yoo¹, Hea Eun HE Kim², Soo Kyoung SK Park¹, Yoo Jin YJ Jeong¹, Seo Heui SH Choi,¹, Hyun Joo HJ Seo¹, Yun Sil YS Chang¹, Jeong Meen JM Seo², Won Soon WS Park¹, Suk Koo SK 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

Correspondence Won Soon WS 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.

Keywords :Infant, Very low birth weight, Infant, Extremely low birth weight, Necrotizing enterocolitis, Intestinal perforation, Laparotomy