KUMJ | VOL. 16 | NO. 1 | ISSUE 61 | JAN.-MARCH, 2018
Outcome Analysis of Neonates following Laparotomy for Acute Abdomen: A Prospective Study
Shrestha R, Ranjit A, Prasad A, Kulshrestha R
Abstract: Background
Low and middle-income countries (LMIC) bear the majority of the global pediatric
surgical burden. Despite increasing volume of pediatric surgeries being performed
in LMIC, outcomes of these surgeries in low and middle-income countries remain
unknown due to lack of robust data.
Objective
The objective of our study was to collect data on and evaluate neonatal surgical
outcomes at a tertiary level center in India.
Method
The surgical outcomes data of all neonates undergoing laparotomy between
February 15, 2015 and October 14, 2015, at Sir Ganga Ram Hospital, New Delhi, India
was collected prospectively. Descriptive statistics were used to determine the rates
of various postoperative outcomes.
Result
A total of 37 neonatal surgeries were performed during the study period. The mean
age of the neonates on the day of surgery was 7 days (range: 1-30 days). Most of
the neonates (72.9%, n=27) were males. About 40% (n=15) of the neonates were
preterm and 15 (40.5%) of them were small for gestational age. In our study, 10
neonates (28.6%) needed ventilation for 48 hours or less after surgery and 5 neonates
(13.5%) were kept Nil per Oral (NPO) postoperatively for more than 10 days. Out of
37 neonates, 4 (10.80%) developed a surgical site infection and 8 neonates (21.6%)
had postoperative sepsis. The in-hospital mortality rate among neonates undergoing
laparotomy during the study period was 8.1 deaths per 100 neonates.
Conclusion
Co-ordination of care among pediatric surgeons, neonatologists, nursing and
anesthesia team is required for optimal surgical outcome.
Keyword : Laparotomy, Mortality, Neonatal surgery