Usefulness of peritoneal drainage in extremely low birth weight infants with intestinal perforation: a single-center experience

PURPOSE: Necrotizing enterocolitis and intestinal perforation are the most common surgical emergency in the neonatal intensive care unit. The purpose of this study is to evaluate if peritoneal drainage (PD) is beneficial in extremely low birth weight infants with intestinal perforation. METHODS: Retrospective cohort study of extremely low birth weight infants with a diagnosis of intestinal perforation. They were received primary PD (n = 23, PD group) or laparotomy (n = 13, LAP group). Laboratory and physiologic data were collected and organ failure scores calculated and compared between preprocedure and postprocedures. Data were analyzed using appropriated statistical tests. RESULTS: Between January 2005 and December 2015, 13 infants (male:female = 9:4) received laparotomy. Of 23 infants (male:female = 16:7) received PD, 20 infants received subsequent laparotomy. There were no demographic differences between PD and LAP groups. And there were no differences in total organ score in either group (PD, P = 0.486; LAP, P = 0.115). However, in LAP group, respiratory score was statistically improved between pre- and postprocedure organ failure score (P = 0.02). In physiologic parameter, PD group had a statistically worsening inotropics requirement (P = 0.025). On the other hand, LAP group had a improvement of PaO(2)/FiO(2) ratio (P = 0.01). CONCLUSION: PD does not improve clinical status in extremely low birth weight infants with intestinal perforation.