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Complication rates in very low and extremely low birth weight infants following laparotomy: a prospective study

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Abstract

Introduction

Surgical site occurrences (SSO), including surgical site infection, dehiscence, and incisional hernia, are complications following laparotomy. SSO rates in premature neonates are poorly understood. We hypothesize that SSO rates are higher among extremely low birth weight (ELBW) infants compared to very low birth weight (VLBW) infants and strive to determine the optimal abdominal closure method for these infants.

Methods

We conducted a prospective observational study of infants < 1.5 kg (kg) undergoing laparotomy at two institutions from 1/1/2020 to 5/1/2022. Patients were grouped by weight and closure; SSO rates were computed and the association tested using Fisher’s exact test.

Results

We identified 59 patients and 104 total operations. At initial surgery, 37 patients weighed < 1 kg (ELBW); 22 patients weighed 1–1.5 kg (VLBW). Complication rate for ELBW was 6(16%) vs. 2(9%) in VLBW, but not significant (p = 0.45). More complications followed a single-layer compared to a two-layer closure (18 vs. 2), but not significant (p = 0.30).

Conclusions

SSO rates are higher for ELBW infants undergoing laparotomy, and fewer complications follow two-layer closure. However, these findings did not reach statistical significance. Further studies are needed to identify modifiable factors to reduce postoperative complications in these infants.

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Data availability

The data for this study is available upon request.

Abbreviations

ELBW:

Extremely low birthweight

kg:

Kilogram

SSO:

Surgical site occurrence

VLBW:

Very low birthweight

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Funding

This research did not receive any specific grant from the funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, New York, NY, 10029, USA

    Linda T. Li

  2. Department of Pediatric Surgery, McGovern Medical School at UTHealth Houston, 6431 Fannin St., Houston, TX, 77030, USA

    Nutan B. Hebballi, Thian Nguyen, Christina Morice & Kevin P. Lally

  3. Children’s Memorial Hermann Hospital, 6411 Fannin St., Houston, TX, 77030, USA

    Kevin P. Lally

Authors
  1. Linda T. Li
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  2. Nutan B. Hebballi
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  3. Thian Nguyen
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  4. Christina Morice
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  5. Kevin P. Lally
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Contributions

LL wrote the initial draft of the main manuscript text and created the database used for data management. NH performed the statistical analysis and prepared the tables. TN and CM collected data for the study and provided major edits to the main manuscript. KL developed the research question and supervised the research design, methodology, and provided major edits to the main manuscript. All authors reviewed the final manuscript.

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Correspondence to Linda T. Li.

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Li, L.T., Hebballi, N.B., Nguyen, T. et al. Complication rates in very low and extremely low birth weight infants following laparotomy: a prospective study. Pediatr Surg Int 39, 237 (2023). https://doi.org/10.1007/s00383-023-05520-z

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