Depth of bacterial invasion in resected intestinal tissue predicts mortality in surgical necrotizing enterocolitis.
Depth of bacterial invasion in resected intestinal tissue predicts mortality in surgical necrotizing enterocolitis.
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DOI：
10.1038/jp.2015.51
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发表时间：
2015-09
期刊：
影响因子：
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通讯作者：
Maheshwari A
中科院分区：
文献类型：
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作者：
Remon JI;Amin SC;Mehendale SR;Rao R;Luciano AA;Garzon SA;Maheshwari A
多达三分之一的婴儿谁发展坏死性小肠结肠炎（NEC）需要手术切除坏死肠。我们假设，在阑尾切除肠的组织病理学发现可以预测这些婴儿的临床结果。我们回顾了10年来在地区转诊中心接受NEC肠切除/尸检的所有患者的病历和存档病理学标本。根据坏死、炎症、细菌侵入和积气的深度和严重程度对病理学标本进行分级，并将组织病理学结果与临床结局相关。我们对33例确诊为NEC的婴儿进行了临床病理分析，其中18例（54.5%）死亡。切除的肠组织中的细菌侵入深度预测NEC的死亡（细菌侵入深度每单位变化的优势比为5.39，95%置信区间为1.33-21.73）。在切除肠的手术边缘存在透壁坏死和细菌也与死亡率增加有关。细菌在切除肠组织中的浸润深度可预测外科NEC的死亡率。
Up to a third of all infants who develop necrotizing enterocolitis (NEC) require surgical resection of necrotic bowel. We hypothesized that the histopathological findings in surgically-resected bowel can predict the clinical outcome of these infants. We reviewed the medical records and archived pathology specimens from all patients who underwent bowel resection/autopsy for NEC at a regional referral center over a 10-year period. Pathology specimens were graded for the depth and severity of necrosis, inflammation, bacteria invasion, and pneumatosis, and histopathological findings were correlated with clinical outcomes. We performed clinico-pathological analysis on 33 infants with confirmed NEC, of which 18 (54.5%) died. Depth of bacterial invasion in resected intestinal tissue predicted death from NEC (odds ratio 5.39 per unit change in the depth of bacterial invasion, 95% confidence interval 1.33-21.73). The presence of transmural necrosis and bacteria in the surgical margins of resected bowel was also associated with increased mortality. Depth of bacterial invasion in resected intestinal tissue predicts mortality in surgical NEC.