Use of neonatal intensive care unit as a safe place for neonatal surgery
a Department of Neonatology,
University Hospital Maastricht, The Netherlands, b Department of Paediatric Surgery, c Department of Neurosurgery
Correspondence to: Dr AWD Gavilanes, Department of Paediatrics, Division of Neonatology, PO Box 5800, 6202 AZ Maastricht, The Netherlands.
Accepted 1 October 1996
AIM
To evaluate the advantages,
disadvantages, and short term morbidity and mortality of major surgical
interventions performed in the neonatal intensive care unit.
METHODSA retrospective case review of 45 neonates
was performed from April 1991 to September 1995. The
characteristics of the patients were: gestational age 29 (SD 4) weeks
(range 24 to 41 weeks); birthweight 1305 (870) g ( range 540 to 4040 g); presurgical weight 1430 (895) g ( range 550 to 4370 g);
postconceptional age at surgery 31 (4) weeks (26 to 47 weeks). The
indications for surgery were: ligation of patent ductus arteriosus
(n=16); insertion of a subcutaneous ventricular catheter reservoir for
hydrocephalus (n=14); repair of congenital diaphragmatic hernia (n=2);
open lung biopsy (n=1); and laparotomies (because of necrotising
enterocolitis, anorectal malformations, and intestinal obstructions)
(n=12). The management of these neonates at laparotomy was: bowel
resection with stomas (n=8) and stomas (n=4). No specially designed
area was used to perform surgery.
RESULTSLocal or systemic infection associated
with surgery was not seen and no perioperative mortality was related to
the surgical procedure.
CONCLUSIONSThe neonatal intensive care unit is
suitable for major surgery during the neonatal period and no special
area is needed to perform complication free surgery.
© 1997 by Archives of Disease in Childhood
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