Laparoscopic treatment of postnecrotizing enterocolitis colonic strictures.
The current report is a multicenter study of a series of infants who developed colonic strictures (CS) as a sequelae of necrotizing enterocolitis (NEC) and who were treated successfully with laparoscopic intestinal resection and primary anastomosis. During 2005-2008, 11 neonates (gestational ages, 32-38 weeks), with a mean birth weight of 1.7 kg (range, 0.96-2.2) and a mean weight at operation of 3.04 kg (range, 1.6-4.4 were approached laparoscopically, following the diagnosis of a post-NEC-CS. The two surgical techniques were: 1) laparoscopic mobilization with extracorporeal resection and anastomosis (LERA) in 4 (36%) and 2) laparoscopic mobilization with intracorporeal resection and anastomosis (LIRA) in 7 (64%) patients. Laparoscopy was effectively performed in all cases without conversion to open surgery. The median operative time was 93 minutes (range, 80-121). The anastomosis was colocolic in all patients, except in 1 case, in which it was colorectal. There were no operative complications. All babies recovered uneventfully and started oral feeding at a median time of 3.5 days (range, 1-11) postoperatively. Hospital discharge was at a median time of 9 days (range, 2-29) following operation. No recurrent strictures have developed.
Journal of laparoendoscopic & advanced surgical techniques. Part A
Anastomosis, Surgical; Colonic Diseases; Constriction, Pathologic; Enterocolitis, Necrotizing; Humans; Infant, Newborn; Intestines; Laparoscopy; Retrospective Studies
necrotizing enterocolitis; NEC; Colonic diseases
Martinez-Ferro, M., Rothenberg, S., St Peter, S. D., Bignon, H., Holcomb, G. W. Laparoscopic treatment of postnecrotizing enterocolitis colonic strictures. Journal of laparoendoscopic & advanced surgical techniques. Part A 20, 477-480 (2010).