First trial on life-threatening condition finds two surgical approaches have same results

May 25, 2006

PITTSBURGH - A nationwide clinical trial involving researchers at Children's Hospital of Pittsburgh compared two radically different surgical procedures to treat an often fatal intestinal disorder in premature infants and found nearly identical results.

Results of the study, led by Yale University and conducted at 15 medical centers in the United States and Canada, are published in the May 25, 2006, issue of The New England Journal of Medicine. It is the first multicenter randomized controlled trial in the nation to compare two surgical approaches in children.

The study involved 117 premature infants who experienced perforation of the intestine because of necrotizing entercolitis (NEC). This is a potentially life-threatening condition treated with two thoroughly different surgical procedures, one invasive and one much less so.

For 30 years, surgeons have debated which approach produces better results, according to the study authors, including David J. Hackam, MD, PhD, a pediatric surgeon at Children's and assistant professor of surgery, cell biology and physiology at the University of Pittsburgh School of Medicine and Barbara Gaines, MD, also a pediatric surgeon at Children's and assistant professor of surgery at the University of Pittsburgh School of Medicine.

"Our study found that patient survival and other major outcomes were essentially the same for these two surgical approaches. This ends three decades of speculation and debate over which approach is more effective," Dr. Hackam said. "Now our efforts can be focused on studying which babies are at greatest risk for developing intestinal perforation due to NEC and then developing new therapies for these at-risk patients."

Dr. Hackam's lab at Children's studies the causes of NEC and seeks to find novel therapies for this devastating disease. NEC is a severe inflammatory disease of the intestine that affects as many as 10,000 premature infants in the United States each year. In extreme cases, NEC leads to perforation of the intestine, a condition that can be fatal if not treated with emergency surgery.

The first, more aggressive surgical procedure - laparotomy and bowel resection - involves a large abdominal incision and removal of all affected intestine. Surgeons then create a stoma, bringing the end of the intestine through a hole in the stomach to drain into a bag. The second procedure - peritoneal drainage - involves making a quarter-inch incision in the lower abdomen and placing a small bag, allowing stool and pus to drain from the abdomen without removal of any intestine.
-end-
For more information on NEC or Children's Pediatric Surgery, please visit www.chp.edu.

Children's Hospital of Pittsburgh

Related Premature Infants Articles from Brightsurf:

Expanded newborn screening could save premature infants' lives
Expanding routine newborn screening to include a metabolic vulnerability profile could lead to earlier detection of life-threatening complications in babies born preterm, according to a study by UC San Francisco researchers.

New machine learning tool predicts devastating intestinal disease in premature infants
Researchers from Columbia Engineering and the University of Pittsburgh have developed a sensitive and specific early warning system for predicting necrotizing enterocolitis (NEC) in premature infants before the life-threatening intestinal disease occurs.

Hormone adjustment may lead to new ways to prevent and treat lung damage in premature infants
Prematurely born babies often need oxygen therapy to prevent brain damage or death.

Revised criteria lead to more accurate screening for eye disease in premature infants
A multicenter group of 41 hospitals led by researchers at Children's Hospital of Philadelphia (CHOP) has confirmed that an improved method for predicting retinopathy of prematurity (ROP), a leading cause of blindness in children, was able to reduce the number of babies having invasive diagnostic examinations by nearly a third, while raising disease detection up to 100 percent.

Deaf infants' gaze behavior more advanced than that of hearing infants
Deaf infants who have been exposed to American Sign Language are better at following an adult's gaze than their hearing peers, supporting the idea that social-cognitive development is sensitive to different kinds of life experiences.

Compared to sustained inflations for extremely premature infants, standard treatment prevails
Preterm infants must establish regular breathing patterns at delivery. For extremely preterm infants requiring resuscitation at birth, a ventilation strategy involving two sustained inflations, compared with standard intermittent positive pressure ventilation, did not reduce the risk of bronchopulmonary dysplasia or death at 36 weeks postmenstrual age.

Cancer causes premature ageing
New research shows that cancer causes premature ageing. Researchers studied Leukaemia, and found that it promotes premature ageing in healthy bone marrow cells.

Checklist helps assess early feeding skills in premature infants
Infants born prematurely face challenges in developing the complex, interrelated skills needed for effective feeding.

Researchers design delivery system to treat premature infants with NEC
Researchers at Nationwide Children's Hospital have developed Lactobacillus reuteri biofilm formulations that protect against experimental necrotizing enterocolitis (NEC).

Majority of premature infants still exposed to early antibiotics
Most premature infants, who are at risk for sepsis but who may not have a culture confirmation of infection, continue to receive early antibiotics in the first few days of life, a finding that suggests neonatal antibiotic stewardship efforts are needed to help clinicians identify infants at lowest risk for infection to avoid unnecessary antibiotic exposure.

Read More: Premature Infants News and Premature Infants Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.