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Odjel djecje kirurgije, Klinicka bolnica Split, Split, Hrvatska.
Acta Med Croatica. 2005;59(4):353-6.
The acute intestinal perforation is the absolute indication for surgical treatment of neonatal necrotizing enterocolitis (NEC). Other symptoms, signs and conditions suggested as indications for surgical treatment are often unclear. Since the beginning of the treatment for NEC there have been the attempts of categorisation to clear which of the patients have really needed conservative or surgical treatment. However, these categories have not been as useful in practice as it had been expected. The problem is not resolved. The indication for surgical treatment of NEC is still based on surgeon's experience in practice. The surgical treatment of NEC is based upon resection of pathologically changed intestine. Whether it performs the primary anastomosis or enterostomy depends of surgeon's estimation which operation will cause less problems to the patient suffering already. There are the attempts to preserve bowel length modificating the operative tactics in selective cases of NEC. Careful nursing and medical care greatly reduce the severity of the disease decreasing both the associated morbidity and mortality. The treatment of NEC appearing in other entities is almost always surgical. It is almost the rule that patients in such cases belong to the group of great risk. Sometimes, in bad condition of the patient only the drainage of the peritoneal cavity is performed. Performing the resection in these cases as well as giving up of the surgical treatment is the question ethics.
急性肠穿孔是新生儿坏死性小肠结肠炎（NEC）外科治疗的绝对指征。其他被认为是外科治疗指征的症状、体征和情况往往并不明确。自开始治疗NEC以来，人们一直试图进行分类，以明确哪些患者真正需要保守治疗或外科治疗。然而，这些分类在实践中的作用并未达到预期。问题仍未解决。NEC的外科治疗指征仍基于外科医生的临床经验。NEC的外科治疗基于对病变肠段的切除。是进行一期吻合还是造口术，取决于外科医生对哪种手术对已经患病的患者造成的问题更少的判断。在NEC的某些选择性病例中，人们试图通过调整手术策略来保留肠管长度。精心的护理和医疗护理可大大降低疾病的严重程度，减少相关的发病率和死亡率。在其他情况下出现的NEC几乎总是需要手术治疗。几乎可以肯定的是，这类病例中的患者属于高风险群体。有时，在患者情况较差时，仅进行腹腔引流。在这些情况下进行切除以及放弃手术治疗是伦理问题。
