WOFAPS 2025 8th World Congress of Pediatric Surgery

Menglei Wang, Chunbao Guo

chongqing health center for women and children

This study aimed to determine the optimal timing of surgical intervention for necrotizing enterocolitis (NEC) in infants. A retrospective review was conducted on infants with modified Bell’s stage 2 or higher NEC from April 2008 to January 2023. The study compared long-term clinical outcomes, including intestinal stricture and bowel loss, among three groups: medical management, surgical intervention with indicator scores ≤5, and surgical intervention with indicator scores >5.

Results showed that infants with indicator scores >5 had more severe disease, lower birth weight, and lower weight at diagnosis. They also had more necrotic bowel resection and longer lengths of resected intestine during initial surgery. The incidence of intestinal stricture was significantly higher in the indicator scores >5 group (42.0%) compared to the medical management group (25.5%) and the indicator scores ≤5 group (17.7%). Additionally, the indicator scores >5 group had more total bowel resection and longer lengths of resected bowel.

The study concluded that early and aggressive surgical intervention for NEC, especially when indicator scores >5, is associated with reduced bowel loss and improved long-term outcomes. However, the decision for surgical intervention should be carefully weighed on a case-by-case basis. Further prospective studies are needed to confirm the optimal timing of surgical intervention.