{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T03:39:32Z","timestamp":1704857972712},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003The aim of this study was retrospective assessment of late major reoperations after surgery for necrotizing enterocolitis (NEC) and spontaneous intestinal perforation (SIP) in neonates.<\/jats:p><jats:p>\n          Materials and Methods\u2003Appropriate ethical consent was obtained. Data collection was by review of hospital records of 165 successive prematures who underwent surgery for NEC (n\u2009=\u200999) or SIP (n\u2009=\u200966) from 1986 to 2019. Outcome measures were late major abdominal surgeries or endoscopies that occurred after the primary surgical treatment, closure of enterostomies, and weaning from parenteral nutrition (PN). We assessed also risk factors for late abdominal surgeries.<\/jats:p><jats:p>\n          Results\u2003Hundred and twenty-six (76%) patients (NEC, n\u2009=\u200970, 71% and in SIP, n\u2009=\u200956, 85%) survived. Median follow-up was 13 (interquartile range: 5.9\u201323) years. Nineteen (15%) patients underwent late abdominal surgery with 0% mortality. Most common was surgery for small bowel obstruction (SBO) in 12(9.5%) patients (NEC, n\u2009=\u20095; 7.0%, SIP, n\u2009=\u20097; 13%, p\u2009=\u20090.36) with 10-year cumulative risk of 8.7 (95% confidence interval [CI]: 3.5\u201314). Long duration of PN and development of intestinal failure associated cholestasis (IFAC) increased the risk of SBO surgery, relative risk: 1.0\u20133.2 (95% CI: 1.0\u20139.1), p\u2009=\u20090.02\u20130.03. Other surgeries included serial transverse enteroplasty (NEC, n\u2009=\u20092), incisional hernia repair (n\u2009=\u20093), cholecystectomy (n\u2009=\u20091), and ovarian torsion (n\u2009=\u20091). Twenty (29%) NEC and four (7%) SIP patients required endoscopic assessment of postoperative symptoms (p\u2009=\u20090.003).<\/jats:p><jats:p>\n          Conclusion\u2003Late abdominal reoperations occurred in 15% of patients with NEC and SIP with nil mortality. SBO was the main indication. Risk of SBO was similar between NEC and SIP. Long PN and IFAC increased the risk of SBO.<\/jats:p>","DOI":"10.1055\/s-0040-1722616","type":"journal-article","created":{"date-parts":[[2021,1,13]],"date-time":"2021-01-13T23:49:17Z","timestamp":1610581757000},"page":"535-540","source":"Crossref","is-referenced-by-count":3,"title":["Late Abdominal Reoperations after Surgery for Necrotizing Enterocolitis and Spontaneous Intestinal Perforation"],"prefix":"10.1055","volume":"31","author":[{"given":"Antti","family":"Koivusalo","sequence":"additional","affiliation":[{"name":"New Children\u0301s Hospital, University of Helsinki, Pediatric Surgery, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristiina","family":"Karila","sequence":"additional","affiliation":[{"name":"New Children\u0301s Hospital, University of Helsinki, Pediatric Surgery, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko","family":"Pakarinen","sequence":"additional","affiliation":[{"name":"New Children\u0301s Hospital, University of Helsinki, Pediatric Surgery, Helsinki, Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,1,13]]},"reference":[{"issue":"03","key":"ref1","first-page":"123","article-title":"The postoperative incidence of small bowel obstruction following standard, open appendectomy and cholecystectomy: a six-year retrospective cohort study at Yale-New Haven Hospital","volume":"57","author":"R I Zbar","year":"1993","journal-title":"Conn Med"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1055\/s-2008-1071041","article-title":"Mechanical small-bowel obstruction after conventional appendectomy in children","volume":"7","author":"G Ahlberg","year":"1997","journal-title":"Eur J Pediatr Surg"},{"issue":"10","key":"ref3","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1016\/j.jpedsurg.2018.07.020","article-title":"Outcomes of surgery for necrotizing 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meta-analysis","volume":"104","author":"E M Hau","year":"2019","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"02","key":"ref13","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1097\/MPG.0000000000000778","article-title":"Intestinal anastomotic ulcers in children with short bowel syndrome and anemia detected by capsule endoscopy","volume":"61","author":"L M Bass","year":"2015","journal-title":"J Pediatr Gastroenterol Nutr"},{"issue":"06","key":"ref14","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1097\/SLA.0b013e318217e99c","article-title":"Adhesion prevention during laparotomy: long-term follow-up of a randomized clinical trial","volume":"253","author":"J B van der Wal","year":"2011","journal-title":"Ann Surg"},{"issue":"02","key":"ref15","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s00383-017-4186-0","article-title":"Laparoscopy or laparotomy for adhesive bowel obstruction in children: a systematic review and 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