Garg Parvesh Mohan, Shenberger Jeffrey S
Department of Pediatrics/Neonatology, Atrium Health Wake Forest Baptist, Wake Forest School of Medicine, Winston Salem, NC, USA.
Department of Pediatrics/Neonatology, Connecticut Children's, Hartford, CT, USA.
J Neonatal Perinatal Med. 2025 Jun 17:19345798251349434. doi: 10.1177/19345798251349434.
Necrotizing enterocolitis (NEC) is a leading cause of death among preterm neonates, leading to increased hospital care and economic burden. Based on all the available randomized control trials and observational studies to date, the peritoneal drain placement is most likely associated with higher mortality than laparotomy when the NEC diagnosis is made prior to the intervention. Peritoneal drainage, however, may be utilized as a bridge treatment in cases where early operation is not possible due to clinical instability or not immediately available. Unfortunately, most studies lack histopathological confirmation of radiographic abnormalities corresponding to NEC or spontaneous intestinal perforation (SIP). Such large prospective studies evaluating the impact of peritoneal drain and laparotomy, which utilize pre-determined histopathologic definitions of NEC/SIP, are necessary to optimize clinical outcomes.
坏死性小肠结肠炎（NEC）是早产新生儿死亡的主要原因，导致住院治疗和经济负担增加。根据迄今为止所有可用的随机对照试验和观察性研究，在干预前做出NEC诊断时，放置腹腔引流管的死亡率很可能高于剖腹手术。然而，在因临床不稳定或无法立即进行早期手术的情况下，腹腔引流可作为一种过渡治疗方法。不幸的是，大多数研究缺乏与NEC或自发性肠穿孔（SIP）相对应的影像学异常的组织病理学确认。有必要进行此类大型前瞻性研究，以评估腹腔引流管和剖腹手术的影响，这些研究采用预先确定的NEC/SIP组织病理学定义，以优化临床结果。
