The optimal treatment in premature infants due to perforated necrotizing enterocolitis as a major cause of morbidity 
and mortality is uncertain remain. Surgical resection of the involved bowel is the standard approach for this condition by creation of intestinal stomas. As the background of the research, the researchers then designed a multicenter randomized trial to compare outcomes of primary peritoneal drainage with laparotomy and bowel resection in preterm infants with perforated necrotizing enterocolitis.
With randomly assigned 117 preterm infants (delivered before 34 weeks of gestation), birth weights less than 1500 g and perforated necrotizing enterocolitis at 15 pediatric centers to undergo primary peritoneal drainage or laparotomy with bowel resection, the researchers stated that primary outcome was survival at 90 days postoperatively and secondary outcomes included dependence on parenteral nutrition 90 days postoperatively and length of hospital stay.
In the result, they found no significant differences in mortality among those who underwent laparotomy and bowel resection as compared with those who underwent primary peritoneal drainage. They also found no significant differences between groups in the dependence on parenteral nutrition 90 days after operation or in the duration of hospital stay in surviving infants.
Finally their current findings do not address the question of whether patients with perforated necrotizing enterocolitis benefit from having any surgical intervention. Thus, it suggest that once necrotizing enterocolitis has progressed to perforation, the type of surgical intervention is not a significant determinant of outcome.
R. Lawrence Moss, M.D. from Yale University School of Medicine, Section of Pediatric Surgery and his colleagues is the author of the journal which named its original tittle as Laparotomy versus Peritoneal Drainage for Necrotizing Enterocolitis and Perforation in the NEJM journal by May 2006 issue. Download full article of "Do Surgical Interventions Have Beneficial Effect to Premature Infants with Perforated Necrotizing Enterocolitis?" in PDF Format from its original tittle and source at nejm.org. Find more Surgery Journal you might look for.
