Multicenter retrospective comparison of spontaneous intestinal perforation outcomes between primary peritoneal drain and primary laparotomy.
J Pediatr Surg
; 55(7): 1270-1275, 2020 Jul.
Article
en En
| MEDLINE
| ID: mdl-31383579
ABSTRACT
PURPOSE:
The purpose of our study was to compare outcomes of infants with spontaneous intestinal perforation (SIP) treated with primary peritoneal drain versus primary laparotomy.METHODS:
We performed a multi-institution retrospective review of infants with diagnosis of SIP from 2012 to 2016. Clinical characteristics and outcomes were compared between infants treated with primary peritoneal drain vs infants treated with laparotomy.RESULTS:
We identified 171 patients treated for SIP (drain nâ¯=â¯110 vs. laparotomy nâ¯=â¯61). There were no differences in maternal or prenatal characteristics. There were no clinically significant differences in vital signs, white blood cell or platelet measures, up to 48â¯h after intervention. Patients who were treated primarily with a drain were more premature (24.9 vs. 27.2â¯weeks, pâ¯<â¯0.001) and had lower median birth weight (710â¯g vs. 896â¯g, pâ¯<â¯0.001). No significant differences were found in complications, time to full feeds, length of stay (LOS) or mortality between the groups. Primary laparotomy group had more procedures (median number 1 vs. 2, pâ¯=â¯0.002). There were 32 (29%) primary drain failures whereby a laparotomy was ultimately needed.CONCLUSIONS:
SIP treated with primary drain is successful in the majority of patients with no significant differences in outcomes when compared to laparotomy with stoma. THE LEVEL OF EVIDENCE III.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Drenaje
/
Perforación Intestinal
/
Laparotomía
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
Límite:
Female
/
Humans
/
Infant
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Male
/
Newborn
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article