Hernia

, Volume 18, Issue 3, pp 351–356

Postoperative outcome in premature infants with open abdomen

Authors

    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
  • M. Binnebösel
    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
  • A. Röth
    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
  • T. Orlikowsky
    • Neonatology Section, Department of Paediatric and Adolescent MedicineRWTH Aachen University Hospital
  • U. P. Neumann
    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
  • G. Steinau
    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
  • C. D. Klink
    • Department of General, Visceral and Transplantation SurgeryRWTH Aachen University Hospital
Original Article

DOI: 10.1007/s10029-014-1226-8

Cite this article as:
Lambertz, A., Binnebösel, M., Röth, A. et al. Hernia (2014) 18: 351. doi:10.1007/s10029-014-1226-8

Abstract

Background

Premature infants treated with laparostomy in the first days of their life represent a group of complex patients with high morbidity and mortality rates. Laparostomy is a surgical treatment method in which the peritoneal cavity is opened anteriorly and deliberately left open, hence often called “open abdomen”. The aim of this study was to analyze crucial factors influencing the postoperative outcome of premature infants treated this way.

Methods

Between March 2002 and August 2012, we treated 40 premature infants with a median gestational age of 29 weeks (range from 24 to 34 weeks) with open abdomen in our institution. Their data were analyzed retrospectively. They were divided into two groups depending on in-hospital survival.

Results

Indications for surgery were ileus (n = 16), spontaneous intestinal perforation (n = 11), gastroschisis (n = 8) and necrotizing enterocolitis (NEC, n = 5). The overall in-hospital mortality was 43 % (17 of 40 patients). Postoperative anemia was the only significant factor influencing mortality rates in our patients (10 vs. 14 patients; p = 0.028). Neither the indication of surgery, nor week of gestation, nor birth weight had any significant influence on postoperative survival. Twenty-one of the 23 surviving patients reached fascia closure.

Conclusions

In our study, outcome of premature infants with open abdomen in the first days of their life seems to depend more on an operation and a postoperative course without complications than on the preoperative conditions of the children. Postoperative anemia seems to be a significant negative prognostic marker. Patients reaching fascia closure mainly survive.

Keywords

Premature infants Open abdomen Mortality Postoperative outcome Fascia closure

Copyright information

© Springer-Verlag France 2014