Use of neonatal intensive care unit as a safe place for neonatal surgery

Aim-To evaluate the advantages, disadvantages, and short term morbidity and mortality of major surgical interventions performed in the neonatal intensive care unit. Methods-A retrospective case review of 45 neonates was performed from April 1991 to September 1995. The characteristics of the patients were: gestational age 29 (SD 4) weeks (range 24 to 41 weeks); birthweight 1305 (870) g (range 540 to 4040 g); presurgical weight 1430 (895) g (range 550 to 4370 g); postconceptional age at surgery 31 (4) weeks (26 to 47 weeks). The indications for surgery were: ligation of patent ductus arteriosus (n=16); insertion of a subcutaneous ventricular catheter reservoir for hydrocephalus (n=14); repair of congenital diaphragmatic hernia (n=2); open lung biopsy (n=1); and laparotomies (because of necrotising enterocolitis, anorectal malformations, and intestinal obstructions) (n=12). The management of these neonates at laparotomy was: bowel resection with stomas (n=8) and stomas (n=4). No specially designed area was used to perform surgery. Results-Local or systemic infection associated with surgery was not seen and no perioperative mortality was related to the surgical procedure. Conclusions-The neonatal intensive care unit is suitable for major surgery during the neonatal period and no special area is needed to perform complication free surgery.