Gao SS, Guan XX, Miu XX, Yu SL, Zhu XP. Risk factors analysis and management strategy optimization for postoperative complications in neonatal necrotizing enterocolitis: A single-center retrospective study. World J Gastrointest Surg 2026; 18(10): 121417 [DOI: 10.4240/wjgs.121417]
Corresponding Author of This Article
Sheng-Lin Yu, MD, Chief Physician, Department of Neonatology, Children’s Hospital of Soochow University, No. 92 Zhongnan Street, Industrial Park, Suzhou 215000, Jiangsu Province, China. wm19711011@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Oct 27, 2026; 18(10): 121417 Published online Oct 27, 2026. doi: 10.4240/wjgs.121417
Risk factors analysis and management strategy optimization for postoperative complications in neonatal necrotizing enterocolitis: A single-center retrospective study
Sha-Sha Gao, Xin-Xian Guan, Xin-Xin Miu, Sheng-Lin Yu, Xue-Ping Zhu, Department of Neonatology, Children’s Hospital of Soochow University, Suzhou 215000, Jiangsu Province, China
Co-first authors: Sha-Sha Gao and Xin-Xian Guan.
Co-corresponding authors: Sheng-Lin Yu and Xue-Ping Zhu.
Author contributions: Gao SS and Guan XX contributed equally to this study as co-first authors, including study design, data collection, statistical analysis, and manuscript drafting and revision; Yu SL and Zhu XP jointly provided project guidance, conducted quality control, critically revised the manuscript, and took overall responsibility for the study as co-corresponding authors; Miu XX participated in data collation, literature review, and manuscript proofreading. All the authors have read and approved the final version of the manuscript.
AI contribution statement: The authors declare that no AI tools were used in the development or writing of this manuscript and take full responsibility for its integrity, accuracy, and originality.
Institutional review board statement: This study has been reviewed and approved by the Medical Ethics Committee of Children’s Hospital of Soochow University, No. 2026CS028.
Informed consent statement: All the individuals who participated in this study provided their written informed consent prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Corresponding author: Sheng-Lin Yu, MD, Chief Physician, Department of Neonatology, Children’s Hospital of Soochow University, No. 92 Zhongnan Street, Industrial Park, Suzhou 215000, Jiangsu Province, China. wm19711011@sina.com
Received: April 28, 2026 Revised: June 11, 2026 Accepted: July 3, 2026 Published online: October 27, 2026 Processing time: 171 Days and 8.4 Hours
Abstract
BACKGROUND
Neonatal necrotizing enterocolitis (NEC) is severe with high morbidity and mortality, and postoperative complications seriously affect prognosis.
AIM
To investigate the risk factors for postoperative complications in neonates with necrotizing enterocolitis (NEC) and provide evidence for optimizing perioperative management.
METHODS
Clinical data of 62 NEC infants undergoing exploratory laparotomy at the Children’s Hospital of Soochow University from August 2022 to September 2025 were retrospectively analyzed. The patients were divided into complication and non-complication groups based on the occurrence of major postoperative complications. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for postoperative complications.
RESULTS
Among the 62 infants, 28 (45.16%) developed major postoperative complications, with septic shock being the most common (25.81%). Combined univariate and multivariate logistic regression analysis showed that preoperative hemodynamic instability [odds ratio (OR) = 5.32, 95% confidence interval (CI): 1.84-15.39], intestinal resection length > 30 cm (OR = 4.18, 95%CI: 1.51-11.56), albumin < 30 g/L on postoperative day 3 (OR = 3.77, 95%CI: 1.42-10.00), and postoperative mechanical ventilation duration > 7 days (OR = 3.25, 95%CI: 1.21-8.74) were independent risk factors for postoperative complications of NEC (P < 0.05).
CONCLUSION
The occurrence of postoperative complications in neonates with NEC is closely related to the preoperative hemodynamic status, surgical extent, and early postoperative recovery. Perioperative circulatory support, refined surgical planning, early nutritional support, and respiratory management should be strengthened to reduce the risk of complications and to improve the prognosis of affected infants.
Core Tip: This retrospective study analyzed 62 neonates with necrotizing enterocolitis who underwent laparotomy. Four factors were associated with an increased risk of postoperative complications. These include problems with preoperative blood pressure, long intestinal resection, low postoperative albumin levels, and long-term mechanical ventilation. These findings provide evidence for improving patient management before and after surgery.
