USE OF NEONATAL INTENSIVE-CARE UNIT AS A SAFE PLACE FOR NEONATAL SURGERY

Aim-To evaluate the advantages, disadvantages, and short term morbidit y and mortality of major surgical interventions performed in the neona tal intensive care unit. Methods-A retrospective case review of 45 neo nates was performed from April 1991 to September 1995. The characteris tics of the patients were: gestational age 29 (SD 4) weeks (range 24 t o 41 weeks); birthweight 1305 (870) g (range 540 to 4040 g); presurgic al weight 1430 (895) g (range 550 to 4370 g); postconceptional age at surgery 31 (4) weeks (26 to 47 weeks). The indications for surgery wer e: ligation of patent ductus arteriosus (n=16); insertion of a subcuta neous 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 malforma tions, and intestinal obstructions) (n=12). The management of these ne onates at laparotomy was: bowel resection with stomas (n=8) and stomas (n=4). No specially designed area was used to perform surgery. Result s-Local or systemic infection associated with surgery was not seen and no perioperative mortality was related to the surgical procedure. Con clusions-The neonatal intensive care unit is suitable for major surger y during the neonatal period and no special area is needed to perform complication free surgery.