Current status of surgical treatment for neonatal necrotizing enterocolitis
Necrotizing enterocolitis(NEC)is a common disease in the newborn period.In the past,the traditional cognition believed that surgical intervention was only needed when abdominal and intestinal perforation occured.However,with the continuous understanding of the pathological course of necrotizing enterocolitis,people began to look for early surgical intervention methods.At present,the relative indications for requiring surgical intervention are mainly based on the parameters of clinical manifestations,laboratory examination and radiological examination.Once the clinical condition of the child is found to deteriorate,surgical intervention is required.The surgical management of NEC includes the following types.The abdominal placement of abdominal drainage tube:the simple placement of abdominal drainage can be used as the final choice for some children with poor general conditions who can't tolerate surgery or with unstable vital signs in the rescue.Open exploration:intestinal stomy or anastomosis can be done after necrotic bowel resection,especially in children with NEC with localized lesions,who can have intestinal anastomosis.In severe,multifocal NEC,due to the more diseased bowel tubes,jejunostomy with high position or"clip and drop back"technology is used to improve the survival rate of children;Use of laparoscopy in NEC:few cases are reported at home and abroad.This technique exacerbates intraabdominal CO2 pressure in children with emergencies,increases the risk of anesthesia and internal environmental deterioration in the children.There are no additional data to support the widespread use of this technology in children with NEC.
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