Cause analyses and countermeasures of 40 neonates of unplanned second surgery

Objective To explore the causes and countermeasures for neonates of unplanned second surgery so as to raise the level of medical technology and lower the rate of unplanned second surgery. Methods Retrospective analyses were performed for 40 neonatal cases of unplanned second surgery for congenital intestinal disease from January 2005 to December 2014. There were 29 boys and 11 girls with a mean age 6.539 days. Their mean hospital stay was 26.2 days according to the mean interval of reoperation and initial operation at 11.4 days. Unplanned second surgery was performed for various reasons. And the causes and countermeasures of unplanned second surgery were analyzed. Results The rate of unplanned second surgery of past 5 years was 2.6%, 1.7% for recent 5 years and it declined by 0.9%. The causes of unplanned second surgery were intestinal obstruction (n=15, 37.5%), anastomotic leakage (n=6, 15.0%), anastomotic dehiscence (n=7, 17.5%), perforation of digestive tract (n=7, 17.5%), necrotizing enterocolitis (NEC)(n=3, 7.5%), intestinal malrotation & torsion (n=2, 5.0%). And the outcomes were healing (n=34), automatic discharge (n=5) and death (n=1). During a 3-month follow-up, except for 2 cases of NEC with low intestinal obstruction, the remainder recovered well. Conclusions Unplanned secondary surgery is harmful. And strengthening perioperative monitoring and standardizing operative procedures can effectively reduce its incidence. Key words: Infant, newborn; Surgery, repeat; Congenital defects