Clinical Spectrum and Outcomes of Neonatal Necrotizing Enterocolitis

Gałązka, Przemysław; Chrzanowska‐Wodnicka, Magdalena; Styczyński, Jan

doi:10.21873/invivo.12295

Cited by 8 publications

(4 citation statements)

References 16 publications

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“…The secondary objective was the risk factors analysis in the context of short-term and mid-term follow-up status. With our experience in minimally invasive surgery (15)(16)(17)(18), we present our data showing that outcome in terms of surgery-dependent morbidity of patients with EA treated with thoracoscopic method might improve previously reported results (Table 1) (5,6,(19)(20)(21)(22)(23) in the context of a lower rate of leakage and other complications, such as conversion to open surgery, regardless of the prognostic criteria of the classification system.…”

Section: Introductionmentioning

confidence: 55%

Short-term and mid-term effects of thoracoscopic repair of esophageal atresia: No anastomotic leaks or conversions to open technique

2022

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The frequency rate of esophageal anastomosis leaks after thoracoscopic correction of esophageal atresia (EA) in the current literature is reported as 5.6%–24.7% and a conversion rate of 2%–53%. The objective of this retrospective study was to examine the characteristics of EA and analysis of the safety and efficacy of EA repair with the use of the thoracoscopic approach in a single academic center, as well as risk factors analysis in the context of short-term and mid-term follow-up status. A retrospective analysis of the management of all consecutive newborns affected by EA hospitalized in our department over a period between 2013 and 2022, including preoperative, perioperative, and postoperative management, together with the outcome, complications and long-term follow-up status was performed. A total of 38 patients with a median birth weight of 2,570 g (range; 1,020–3,880) were treated over the study period, including 30/38 (78.9%) with additional congenital anomalies. Overall, 30 patients underwent primary anastomosis of the esophagus and eight underwent a multistaged procedure, with or without an initial ligation of the tracheoesophageal fistula and delayed primary anastomosis. Overall survival for all patients was 0.894 ± 0.050, with a median follow-up of 4.5 years. We noted neither anastomotic leaks nor conversions to open technique in our cohort. Implementation of vancomycin prophylaxis was successful in preventing postoperative central venous access-related infectious complications. At the end of the follow-up, 85% of patients have a Lansky performance score ≥80. Risk factors analysis for length of hospitalization, overall survival, Lansky performance status, and neurological impairment were analyzed. In conclusion, we have found that the outcome of thoracoscopic repair of EA in terms of surgery-dependent morbidity (anastomosis leakage, conversion rate to open surgery), provides benefit to those previously reported in the literature, regardless of the prognostic criteria of the classification system.

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Section: Introductionmentioning

confidence: 55%

Short-term and mid-term effects of thoracoscopic repair of esophageal atresia: No anastomotic leaks or conversions to open technique

2022

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“…Multiple risk factors have been recognized, including hypoxia and infection [2,3]. Despite the rapid development of neonatal healthcare, the prevention and treatment of NEC remains a global problem [4,5]. Therefore, the in vitro model of this disease is very important to study the pathophysiological mechanism of this disease [6].…”

Section: Introductionmentioning

confidence: 99%

In Vitro Model stimulated by exposure to single and combined stress factors for Necrotizing Enterocolitis Running title: In Vitro Model stimulated by single and combined factors for NEC

Gao

Feng

Wang

et al. 2023

Preprint

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Purpose Necrotizing enterocolitis (NEC) is a severe gastrointestinal disease in neonates, with high death rate. The pathogenesis of NEC is particularly complex, mainly involving inflammation and hypoxic damage. In vitro cell model is an indispensable tool to study the pathogenesis of NEC. This study explored the effects of different stress factors on intestinal injury in vitro. Methods IEC-6 cells were stimulated by exposure to different stressors, including lipopolysaccharide (LPS), cobalt chloride (CoCl2), and a combination of both. Cell viability was detected by CCK-8 assay. The expression of inflammatory cytokines (IL-6 and TNFα) at the gene and protein levels were measured by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and enzyme-linked immune-sorbent assay (ELISA). While the expression of tight junction proteins (Claudin-1 and zonula occludens [ZO]-1) were evaluated by qRT-PCR and western blotting, respectively. Results The decrease in IEC-6 cell viability was observed after stimulation by CoCl2 alone or in combination with LPS, but not after stimulation with LPS alone. The expression of IL-6 and TNFα increased in each group, especially in the combined stimulation group. After stimulation with CoCl2 alone or in combination with LPS, a decrease in Claudin-1 was observed, but an increase was detected after stimulation with LPS alone. ZO-1 decreased in both mRNA and protein levels after combined stimulation. Conclusion The combined stimulation of CoCl2 and LPS on IEC-6 cells could simultaneously induce severe inflammation and barrier damage, which may better simulate the pathological process of NEC. Further research is needed to determine whether this in vitro model can be used to study the pathogenesis of NEC.

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“…About 30–50% of clinically diagnosed pediatric patients require surgical remedy, but the choice of surgical opportunity is difficult to determine ( 4 ). Ideally, the operation should be performed when the intestinal canal is necrotic but not perforated, which can avoid peritonitis caused by intestinal perforation, relieve the intestinal burden in time, and reduce mortality ( 5 , 6 ). At present, intestinal perforation is the clinical indication of NEC operation, but only a few pediatric patients have typical manifestations of intestinal necrosis.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

Wang¹,

Jin²,

Su³

et al. 2023

Transl Pediatr

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Background Neonatal necrotizing enterocolitis (NEC) is a common gastrointestinal emergency in newborns. Currently, the pathogenesis of the disease remains unknown. This study aims to determine the application value of serum markers in the selection of operation opportunities for NEC. Methods This study consisted of a retrospective analysis of the clinical data of 150 participants with NEC admitted to Maternal and Child Health Hospital of Hubei Province from March 2017 to March 2022. Participants were assigned to an operation group (n=58) and a nonoperation group (n=92) according to the presence or absence of surgical treatment. Serum sample data for serum C-reactive protein (CRP) and interleukin 6 (IL-6), serum amyloid A (SAA), procalcitonin (PCT), and intestinal fatty acid-binding protein (I-FABP) concentrations were estimated. To compare the differences in overall data and serum markers between the 2 groups, independent factors related to surgical treatment in pediatric patients with NEC were analyzed using logistic regression. The utility of serum markers in selecting surgical options in pediatric patients with NEC was analyzed by constructing a receiver operating characteristic (ROC) curve. Results CRP, I-FABP, IL-6, PCT, and SAA levels were higher in the operation group than in the nonoperation group (P<0.05). Multivariate logistic regression analysis confirmed that CRP, I-FABP, IL-6, PCT, and SAA were independent related factors of NEC surgical remedy (P<0.05). Meanwhile, ROC curve analysis yielded a serum CRP, PCT, IL-6, I-FABP, and SAA area under curve (AUC) of NEC operation timing of 0.805, 0.844, 0.635, 0.872, and 0.864, respectively; a sensitivity of 75.90%, 86.20%, 60.30%, 82.80%, and 84.50%, respectively; and a specificity of 80.40%, 79.30%, 68.35%, 80.40%, and 80.55%, respectively. Conclusions The serum markers CRP, PCT, IL-6, I-FABP, and SAA have certain guiding values in the choice of operation opportunity for pediatric patients with NEC.

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Clinical Spectrum and Outcomes of Neonatal Necrotizing Enterocolitis

Cited by 8 publications

References 16 publications

Short-term and mid-term effects of thoracoscopic repair of esophageal atresia: No anastomotic leaks or conversions to open technique

Short-term and mid-term effects of thoracoscopic repair of esophageal atresia: No anastomotic leaks or conversions to open technique

In Vitro Model stimulated by exposure to single and combined stress factors for Necrotizing Enterocolitis Running title: In Vitro Model stimulated by single and combined factors for NEC

Predictive value of serum markers in the operation evaluation of neonatal necrotizing enterocolitis

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