Department of Pediatric Surgery. Hospital de Niños Dr. Roberto Gilbert Elizalde. Guayaquil (Ecuador).
Department of Pediatric Surgery. Hospital de Niños Dr. Roberto Gilbert Elizalde. Guayaquil (Ecuador). Universidad Católica Santiago de Guayaquil (Ecuador).
Cir Pediatr. 2024 Jan 1;37(1):37-41. doi: 10.54847/cp.2024.01.16.
Hostile abdomen is a surgical condition characterized by loss of space between organs and structures in the abdomen. Negative pressure therapy use has been widely described in adults; the case is not the same for pediatric patients. The goal of this study is to present short-term results of negative pressure therapy use in pediatric patients with hostile abdomen due to different etiologies.
Pediatric hostile abdomen patients (< 18 years) who were treated Negative pressure therapy using ABTHERA were identified and retrospectively reviewed.
7 patients were included in this study. Median age was 16 (range: 9-17 yo). 5 (71.4%) were male and 2 (28.6%) females. 3 (43%) had significant past medical/surgical history (Systemic Lupus Erythematosus, complicated appendectomy and ventriculoperitoneal-shunt). The device was set at a continuous pressure ranging from -50 to -125 mmHg. Pre and post-surgical findings were reported using Bjork's classification. Devices were replaced every 4-7 days (median 5 days). Total amount of replacements was 1-4 (median 3). 5 (71.4%) patients required invasive mechanical ventilation during use of Negative pressure therapy based on clinical status. 4 (57%) patients received enteral nutrition. 1 (14%) patient required re-intervention posterior to definitive closure due to retroperitoneal abscess development. Outcome, evaluated by (oral tolerance, bowel movement and absence of pain), was favorable in all patients.
Negative pressure therapy devices generate favorable results in hostile abdomen in pediatric population but further information is needed to assess pressure settings and device replacement frequency.
敌对腹部是一种以腹部器官和结构之间空间丧失为特征的外科病症。负压治疗在成人中已得到广泛描述；但在儿科患者中并非如此。本研究的目的是介绍因不同病因导致敌对腹部的儿科患者使用负压治疗的短期结果。
确定并回顾性分析使用 ABTHERA 接受负压治疗的儿科敌对腹部患者（<18 岁）。
本研究纳入 7 名患者。中位年龄为 16 岁（范围：9-17 岁）。5 名（71.4%）为男性，2 名（28.6%）为女性。3 名（43%）有显著的既往内科/外科病史（系统性红斑狼疮、复杂阑尾切除术和脑室-腹腔分流术）。设备的持续压力设置范围为-50 至-125mmHg。使用 Björk 分类报告术前和术后发现。设备每 4-7 天更换一次（中位数为 5 天）。更换总次数为 1-4 次（中位数为 3 次）。5 名（71.4%）患者根据临床状况需要在使用负压治疗时进行有创机械通气。4 名（57%）患者接受肠内营养。1 名（14%）患者因后腹膜脓肿发展需要在确定性闭合后再次干预。所有患者的结局（通过口服耐受性、肠蠕动和无疼痛来评估）均良好。
负压治疗设备在儿科敌对腹部患者中产生良好的结果，但需要更多信息来评估压力设置和设备更换频率。
