Peculiarities of surgical treatment of children with ulcerous necrotic enterocolitis

Abstract

Ulcerous necrotic enterocolitis is the most severe disease in newborns. In this disorder, lethality reaches 45% in average. It significantly increases when gestational age is reduced reaching 100% and results in peritonitis in children with extremely low body weight (less than 1,000 g). Though surgeons agree upon indications to surgery, approach to the management and surgical treatment of patients with progressive necrotic enterocolitis is still rather contradictory today.Purpose: to improve treatment outcomes in patients with ulcerous necrotic enterocolitits developing the determination method of local necrosis area and level of intestinal resection.Materials and methods: the work was done at the clinics of pediatric surgery of Rostov State Medical University based on the Regional Children’s Clinical Hospital where 58 patients underwent treatment for ulcerous necrotic enterocolitits from 2010 to 2017. In all cases, viability of the entodermal canal was determined using our developed determination method of local necrosis area and level of intestinal resection. Decision on Russian grant dated April 5, 2019 based on application No. 2017143990 dated December 14, 2017.Results: the developed determination method of local necrosis area timely determines necrosis of the intestinal wall at the stage of preperforation until the signs of peritonitis when the intestine is resected with enteroanastamosis. This method also determines the optimal level of intestinal resection within healthy tissues.Conclusions: the method improves the outcomes of surgical treatment and quality of life of patients suffering from this disease and reduces the time of rehabilitation.