Surgical therapy for necrotizing enterocolitis.

Fifty-one infants were treated surgically for necrotizing enterocolitis utilizing a uniform protocol from July 1980 through July 1983. The indications for surgery were pneumoperitoneum or a paracentesis indicative of bowel infarction. Segmental intestinal resection and exteriorization of the bowel ends through the upper abdominal transverse incision was the usual procedure. Intestinal continuity was reestablished when the patient reached 10 pounds, or sooner if he was failing to thrive with his ileostomy. The overall survival was 72.5%, and it was 82% for those patients have a definitive surgical procedure. This survival rate was not adversely affected by the patient's weight or age at the time of operation, nor by the presence of bowel perforation. The 37 survivors endured multiple postoperative complications. The most significant long-term sequela was short-gut syndrome, which occurred in 11% of survivors.