ΠΜΣ Καρδιοαναπνευστική ΑναζωογόνησηLibrary of the School of Health Sciences
Κα.Ν.Ιακωβίδου, Καθηγήτρια , Ιατρική, ΕΚΠΑ
Κος Γ.Γκιόκας , Καθηγητής Ιατρική , ΕΚΠΑ
Κα Σ.Σιαχανίδου , Καθηγήτρια, Ιατρική ,ΕΚΠΑ
Νεκρωτική Εντεροκολίτιδα Νεογνών- σταδίου ΙΙΙ. Ο ρόλος της χειρουργικής παρέμβασης (Η αποτελεσματικότητα της λαπαροτομίας και της περιτοναϊκής παροχέτευσης στην επιβίωση των χαμηλού βάρους νεογνών και των πρόωρων νεογνών με NEΚ σταδίου III).
Neoanatal Necrotising enterocolitis-stage III. The role of surgical intervention.
((The efficacy of laparotomy and peritoneal drainage in the survival of low-weight neonates and preterm newborns with stage III NEC)
Objective: The purpose of this meta-analysis is to investigate whether Laparotomy (LAP) or Peritoneal Drainage (PD) affects survival in the treatment of Necrotizing Enterocolitis (NEC) in premature or low birth weight neonates.
Summary Background Data: Necrotizing Enterocolitis is one of the most common gastrointestinal diseases affecting low birth weight neonates and major cause of mortality. Regardless the progress in research, to date the surgical management of this disease remains controversial.
Methods: We used PRISMA guidelines to conduct a systematic literature search of nine databases up to December 2016. Relevant publications were qualitatively assessed for validity and reliability using the Joanne Briggs Institute (JBI) critical appraisal tools.
Results: From a total of 3.367 potential publications which were identified using search terms, ten relevant studies remained for quantitative assessment. Nine out of ten studies were of high quality. The analysis of the studies revealed moderate heterogeneity (I2= 44%) and no publication bias as indicated by the funnel plot. Evidence from 9/10 studies reported increased survival with laparotomy as compared to peritoneal drainage. The overall effect indicated a small favour to Laparotomy in terms of survival. However this difference between the PD and LAP treatment was not statistically significant (RR:1.20 [0.99,1.46]).
Conclusion: Best medical evidence suggests that laparotomy might be more efficient in the surgical management of low birth weight neonates suffering from NEC. However, peritoneal drainage may be useful as an adjunct therapy prior to laparotomy. Future clinical trials are needed to confirm the findings documented in this meta-analysis.
Main subject category:
Surgery, Necrotizing enterocolitis, Neonates, Premature
Number of references:
bΝεογνική Νεκρωτική Εντεροκολίτιδα σταδίου ΙΙΙ.pdf
File access is restricted only to the intranet of UoA.