Necrotizing enterocolitis (NEC) is a severe inflammatory disorder of the intestine, causing high mortality and morbidity. We investigated the single center experience about the operative indication, treatment method, and mortality in NEC.

The medical records of infants (<1 year old) who underwent the operation due to complications of NEC at the Asan Medical Center from Jan 1997 to Dec 2007 were retrospectively reviewed.

Among 49 patients (M : F = 34 : 15), 37 underwent the operation at acute phase of NEC, average 26.43±35.43 days after birth (3~168), due to pneumoperitoneum in 23, clinical deterioration in 12 and abdominal mass in 2. Average gestational age was 234.64±38.27 days (161~279) and birth weight was 2,061.38±999.49 g (563~3,740). The extent of necrosis was classified grossly as focal in 14 cases, multifocal in 14 and panintestinal in 9 and the operative methods were enterostomy in 30 patients, resection and anastomosis in 6 and open drainage in 1. Thirteen patients (35.1%) were expired - 8 (21.6%) died of necrotizing enterocolitis and 5 died of other causes. The other 12 patients underwent operation for stricture after NEC at average 81.17±77.22 days after birth (32~317). Average gestational age was 240.83±34.4 days (173~280) and birth weight was 2,089.83±862.47 g (710~3,200). Eight patients underwent resection and anastomosis including stricture and 4 patients underwent enterostomy.

Resection and enterostomy was the preferred procedure but resection and anastomosis did not increase morbidity or mortality. Quite a number of patients suffered from the stricture after NEC.