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Necrotising enterocolitis: resection versus drainage
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Standard surgery for intestinal perforation or necrosis at any age is resection of the diseased bowel and intestinal diversion with the creation of stomas. For preterm infants with necrotising enterocolitis (NEC) these procedures are hazardous and 30 years ago surgeons in Toronto reported a series of six infants treated with primary peritoneal drainage as a stabilising measure. Three survived, two without open operation. Since then mortality among infants with NEC has remained at 30–50%. Neurodevelopmental outcome in survivors is often poor. The debate about the merits of treating some infants with primary peritoneal drainage has continued. Now a multicentre trial in the USA and Toronto (
R Lawrence Moss and colleagues. New England Journal of Medicine 2006;354:2225–34
The trial, at 15
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