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  • Is transfer of surgically risk necrotizing enterocolitis to tertiary center is important from the start?

    Nezar A. Abo Halawa1*, Ahmed El-Abd Ahmed2, Sawsan A. Elkhateeb3, Galal H. Galal3
    1Pediatric Unit, General surgery Department , Qena Faculty of Medicine, South Valley University; 2Pediatric Department, Qena Faculty of Medicine, South Valley University;3Pediatric Department, Qena General Hospital

    Background: Necrotizing enterocolitis (NEC) is common devastating inflammatory intestinal disorder of newborns with multisystem organ failure. Disease progression affects about half of all affected infants, in case of surgical interference the mortality rates exceeding 30%. Until now hospital transfer of surgical necrotizing enterocolitis to centers with specialized pediatric surgical expertise remains a dilemma for pediatricians and pediatric surgeons. Objective: compare the mortality and morbidity of infants with surgical risk NEC managed in centers with surgical facilities with similar infants in centers with no surgical facilities. Methods: all neonates suffering from surgically risk necrotizing enterocolitis (Modified Bell’s Staging, stage IIB & Stage IIIA ) in Qena university hospital and Three pediatric centers in Qena are divided into two group:- Group A: (26 neonates in Qena university hospital). -Group B:(37 neonates in the three pediatric centers) Results: As regard to patients, both group are similar in age at presentation, sex, gestational age, residence, weight, presenting manifestations. neonates in group (B)had more hospital stay 50.14 ± 13.98 (p < 0.001), in the other hand more neonates in group (A) need surgical intervention 35.35 ± 9.83 (p = 0.003) with nearly similar outcome as regard mortality in both groups. The length of hospital stay were more among died neonates in both groups, the group (A) (p=0.024) and the group (B) (p=0.04). there was significant correlation between mortality and surgical intervention in the group (B) (p=0.021). Conclusions: There is no significant difference as regard to mortality of neonates with surgical risk NEC managed in centers with surgical facilities compared with similar neonates in centers with no surgical facilities, also more cooperation between pediatric surgeons and pediatrician in our locality have positive implication in the introduction of good care for neonates with NEC. Keywords: Necrotizing enterocolitis, tertiary center, Neonatal Intensive Care Units.