A new classification for surgical NEC during exploratory laparotomy : introduction and reproducibility assessment

© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature..

PURPOSE: Variability in necrosis patterns and operative techniques in surgical necrotizing enterocolitis (NEC) necessitates a standardized classification system for consistent assessment and comparison. This study introduces a novel intraoperative reporting system for surgical NEC, focusing on reliability and reproducibility.

METHODS: Analyzing surgical NEC cases from January 2018 to June 2023 at two tertiary neonatal and pediatric surgery units, a new classification system incorporating anatomical details and intestinal involvement extent was developed. Its reproducibility was quantified using kappa coefficients (κ) for interobserver and intraobserver reliability, assessed by four specialists. Furthermore, following surgery, the occurrence of mortality and enteric autonomy were evaluated on the basis of surgical decision-making of the novel intraoperative classification system for surgical NEC.

RESULTS: In total, 95 patients with surgical NEC were included in this analysis. The mean κ value of the intra-observer reliability was 0.889 (range, 0.790-0.941) for the new classification, indicating excellent agreement and the inter-observer reliability was 0.806 (range, 0.718-0.883), indicating substantial agreement.

CONCLUSION: The introduced classification system for surgical NEC shows high reliability, deepening the understanding of NEC's intraoperative exploration aspects. It promises to indicate operative strategies, enhance prognosis prediction, and substantially facilitate scholarly communication in pediatric surgery. Importantly, it explores the potential for a standardized report and may represent a step forward in classifying surgical NEC, if pediatric surgeons are open to change.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:40

Enthalten in:

Pediatric surgery international - 40(2024), 1 vom: 15. Apr., Seite 108

Sprache:

Englisch

Beteiligte Personen:

Shang, Shuai [VerfasserIn]
Li, Ao [VerfasserIn]
Liang, Chao [VerfasserIn]
Shen, Cuncun [VerfasserIn]
Li, Yingchao [VerfasserIn]
Liu, Lintao [VerfasserIn]
Geng, Na [VerfasserIn]
Xu, Weili [VerfasserIn]
Li, Suolin [VerfasserIn]

Links:

Volltext

Themen:

Classification
Journal Article
Laparotomy
Necrotizing enterocolitis
Reproducibility
Surgical NEC

Anmerkungen:

Date Completed 16.04.2024

Date Revised 16.04.2024

published: Electronic

Citation Status MEDLINE

doi:

10.1007/s00383-024-05685-1

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM371090016