PMID- 21157690
OWN - NLM
STAT- MEDLINE
DCOM- 20110623
LR  - 20110217
IS  - 1439-359X (Electronic)
IS  - 0939-7248 (Linking)
VI  - 21
IP  - 1
DP  - 2011 Jan
TI  - Long-term neurodevelopmental impairment in neonates surgically treated for 
      necrotizing enterocolitis: enterostomy associated with a worse outcome.
PG  - 58-64
LID - 10.1055/s-0030-1267976 [doi]
AB  - BACKGROUND: Necrotizing enterocolitis (NEC) patients often have 
      neurodevelopmental impairment, but the long-term follow-up data is limited. We 
      determined whether surgical factors were of prognostic value for long-term 
      neurodevelopment in children surviving surgery for NEC (SNEC). PATIENTS AND 
      METHODS: SNEC patients born between 1996 and 2002 were tested for verbal (VIQ), 
      performance (PIQ) and total (TIQ) intelligence using Wechsler's Intelligence 
      Scale for Children, Third Edition, Dutch Version, and motor skills using the 
      Movement Assessment Battery for Children (M-ABC). Neonatal and surgical data were 
      obtained retrospectively to assess prognostic factors. RESULTS: 19 patients (12 
      boys), median age 9.9 years (range 6.2-13.1), gestational age 31.0 weeks (range 
      25.2-40), birth weight 1 250 g (range 780-3 175) were evaluated. Infants with an 
      enterostomy (n=14) scored lower on intelligence than children with a primary 
      anastomosis (n=5): VIQ 85 +/- 12 vs. 101 +/- 15, p=0.04; PIQ 79 +/- 13 vs. 92 +/- 11, 
      p=0.06; TIQ 82 +/- 11 vs. 97 +/- 13, p=0.04. Motor skills were either suspect or 
      clinically impaired in 74%. Clinical classification of results suggest more 
      children in the enterostomy group had a performance rated as clinically impaired 
      compared to the primary anastomosis group, although no statistical difference in 
      M-ABC score was found. There were no differences between primary anastomosis and 
      enterostomy patients with regard to gestational age, birth weight, comorbidities, 
      preoperative Bell stage, residual small and large bowel lengths, inotropic 
      medication, duration of ventilatory support, NICU and hospital stay, and physical 
      exam data on follow-up. However, a selection bias could not be ruled out. 
      CONCLUSIONS: The results suggest that an enterostomy in SNEC patients could be 
      associated with worse neurodevelopmental outcomes by the age of 6-13 years 
      compared to a primary anastomosis, although the severity of illness was 
      comparable between both groups. Further studies are needed to prevent selection 
      bias and to elucidate the impact of abdominal surgical factors on 
      neurodevelopmental outcome and the underlying pathophysiology.
CI  - (c) Georg Thieme Verlag KG Stuttgart . New York.
FAU - Ta, B D P
AU  - Ta BD
AD  - University Medical Center Groningen, Department of Pediatric Surgery, Groningen, 
      The Netherlands. bastiaanta@gmail.com
FAU - Roze, E
AU  - Roze E
FAU - van Braeckel, K N J A
AU  - van Braeckel KN
FAU - Bos, A F
AU  - Bos AF
FAU - Rassouli-Kirchmeier, R
AU  - Rassouli-Kirchmeier R
FAU - Hulscher, J B F
AU  - Hulscher JB
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20101214
PL  - United States
TA  - Eur J Pediatr Surg
JT  - European journal of pediatric surgery : official journal of Austrian Association 
      of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie
JID - 9105263
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Cognition Disorders/*etiology
MH  - Developmental Disabilities/*etiology
MH  - Enterocolitis, Necrotizing/*surgery
MH  - *Enterostomy
MH  - Female
MH  - Humans
MH  - Male
MH  - Nervous System Diseases/*etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2010/12/16 06:00
MHDA- 2011/06/24 06:00
CRDT- 2010/12/16 06:00
PHST- 2010/12/16 06:00 [entrez]
PHST- 2010/12/16 06:00 [pubmed]
PHST- 2011/06/24 06:00 [medline]
AID - 10.1055/s-0030-1267976 [doi]
PST - ppublish
SO  - Eur J Pediatr Surg. 2011 Jan;21(1):58-64. doi: 10.1055/s-0030-1267976. Epub 2010 
      Dec 14.