Ishod bolesnika nakon kirurškog liječenja nekrotizirajućeg enterekolitisa

master's thesis

• Title (english): Patient outcomes following surgical treatment of necrotizing enterocolitis
• Author: Petra Živković
• Mentor: Ruža Grizelj (mentor)
• Committee member: Duška Tješić-Drinković (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Ruža Grizelj (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Nekrotizirajući enterokolitis (je životno ugrožavajuća upalna bolest crijeva koja nastaje u novorođenčadi najčešće u nedonoščadi Karakterizira je upalna ozljeda stijenke crijeva koja se može komplicirati nekrozom i perforacijom Cilj ovog retrospektivnog
istraživanja bio je opisati karakteristike i prikazati ishode nedonoščadi koji su operirani zbog nekrotizirajućeg enterokolitisa u Kliničkom bolničkom centru Zagreb od 2015. do 2019. godine. U istraživanje je uključ eno 23 ispitanika gestacijske dobi 23 do 36 (27,7± 3,7) tjedana. Medijan dobi prilikom operacije iznosio je 11 (5-43) dana. Bilo je 83% muških ispitanika. Prenatalna kortikosteroidna profilaksa provedena je u svega 52%. U većine bolesnika (n=14) primarna intervencija bila je eksplorativna laparotomija, troje je izliječeno postavljanjem primarne peritonealne drenaže, dok je u šestero ispitanika nakon primarne peritonealne drenaže bila indicirana laparotomija. Svi bolesnici su preživjeli. Medijan trajanja hospitalizacije bio je 128 dana (15-430), jedan je bolesnik kao komplikaciju razvio sindrom kratkog crijeva, petero (sepsu, osmero (retinopatiju prematuriteta koja je zahtijevala operaciju, a intrakranijalno krvarenje ≥III stupnja je dijagnosticirano u sedam (30%) bolesnika. Nije bilo značajne razlike u ishodi ma bolesnika s obzirom na primarni modalitet operacijskog liječenja. Mortalitet zbog nekrotizirajućeg enterokolitisa u našem istraživanju manji je u usporedbi s drugim visokorazvijenim zemaljama. Primarna peritonealna drenaža u bolesnika visokorizičnih za primarnu eksplorativnu laparotomiju i resekciju crijeva pokazala se jednakovrijednom metodom liječenja. Razlika u nastanku komplikacija i mortalitetu među skupinama bolesnika liječenim različitim operacijskim pristupima nije bilo.

Abstract (english)

Necrotizing enterocolitis ( is a life threatening inflammatory bowel disease that occurs in the newborn, most often in preterm infants. It is characterized by inflammation and injury of the intestinal wall that can be complicated by necrosis and perforation. The purpose of this study was to characterize the population and evaluate risk factors, surgi cal treatments
and short term outcomes in preterm infants with surgical necrotizing enterocolitis (We retrospectively evaluated premature infants with surgical NEC over a period of 5 years (2015-2019) in a Croatian tertiary referral centre. This study included 23 outborns aged 23 to 36 weeks of gestation (27.7 ± 3.7). The median age at surgery was 11 days (5-43 days). Male gender
(was overrepresented, whereas antenatal steroid exposure was low (The majority of patients (n=14 had a primary laparotomy (61%); three patients had peritoneal drainage (PD) alone (13%) and six patients had PD followed by laparotomy. All patients survived. After referral, the median length of hospitalization was 128 days (15-430 days), one patient developed short bowel syndrome five (22%) were treated for sepsis, eight patients (35%) received laser photocoagulation due to retinopathy, and grade 3 to 4 intraventricular hemorrhages were diagnosed in seven (30%) patients. There were no differences in outcomes related to surgical approach. NEC mortality in our cohort is lower than current literature suggests. Additionally, abdominal drainage seems to be equally successful treatment of NEC as explorative laparatomy and bowel resection in neonates who do not meet the criteria for the latter procedures. Neonates who underwent abdominal drainage do not show increased probability of complications or higher lethality.

• Keywords: nekrotizirajući enterokolitis; ishod; laparotomija; primarna peritonealna drenaža
• Keywords (english): necrotizing enterocolitis; outcomes; laparotomy; primary peritoneal drainage
• Language: croatian
• URN:NBN: urn:nbn:hr:105:878125
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-07-30 07:15:29