283 The Role of Peritoneal Drainage in Bell's Stage 2 of Necrotizinf Enterocolitis

Abstract

Introduction Necrotizing enterocolitis (NEC) has become the most common perinatal gastrointestinal emergency. In literature there is an ongoing discussion on which surgical approach is the most efficient to maximise patients' survival: laparotomy or percutaneous drainage in case of intestinal perforation. The aim of this study is to identify the preventive role of the peritoneal drain. Materials and Methods Between September 2007 and September 2011 a prospective study was carried out at our Hospital. Informed consent were obtained by parents before treatment; Inclusion criteria were created. Group A: placement of abdominal drainage in stage 2; Group B: surgical treatment only with perforation. Efficacy of early treatment (absence of subsequent intestinal perforation) was the primary end point; Survival at one month after drainage placement, Hospitalization, Mortality and Morbidity were considered for analysis. Results 43 infants with stage II NEC were observed. At the end of the study the results shows that: 16 patients were treated with preventive peritoneal drain; 4 of these patients (25%) underwent surgery for advanced NEC (intestinal perforation). Of the other 27 patients, 10 patients (37%) developed advanced NEC, with intestinal perforation. (p<0.05) in each group Patients with advanced NEC showed longer time of meconium evacuation if compared to the others (mean 5 vs. 2 days, p<0.05). Only 25% of patients treated with PPD underwent laparotomy for bowel perforation (p<0.05). Conclusions The use of peritoneal drain in stage II NEC seems to be a safe alternative and treatment for these patients.