Udo Rolle | Conference 2019 Skip to main content

Newborn Surgery – The way from survival to quality of life – long-term developmental follow up

 

Udo Rolle, Antje Allendorf

 

Department of Paediatric Surgery and Paediatric Urology, Department of Neonatology

University-Hospital of the Goethe-University

Frankfurt/M., Germany

 

Abstract

 

Background:   Severe congenital anomalies and relevant intestinal disorders (necrotizing enterocolitis-NEC) carry a high risk of morbidity and mortality. Nevertheless, the progress of neonatal, intensive care and paediatric surgical treatment resulted in a high survival rate in this patient population. Major surgery and anesthesia in newborn age might lead to a neurodevelopmental delay. We, therefore, investigated the neurodevelopmental outcome of newborn patients treated for major gastrointestinal malformation and NEC at a 2-year follow-up.

Methods: Patients with relevant congenital gastrointestinal tract malformations (n=40) and NEC (non-surgical Group A, n=13, surgical Group B, n=24) were identified. Neonatal characteristics and anesthesia data were retrospectively collected. Based on information about neonatal characteristics and socioeconomic background, a matched pair was found. All participants were tested at the corrected age of 24 months with the Bayley Scales of Infant Development II-Assessment.

Results: The outcome was split into the psychomotor (PDI) and the mental developmental index (MDI). The congenital gastrointestinal patient group achieved a mean PDI of 103, the peer group 106; these were not significantly different. The mean MDI was 102 in the patient group and 110 in the control group. This difference was significant (p=0.022). Detailed analysis of the items showed no significance for non-verbal items; however, there was a significant difference in verbal items (p=0.029). Further analysis showed no correlation between relevant anesthesia data and the neurodevelopmental outcome.

The non-operated NEC group achieved a mean PDI of 106, and those in the operated group achieved a mean PDI of 90. These values were significantly better in the non-operated group. The mean MDI´s were 99 in the non-operative NEC group and 85 in the operated NEC group, with a significant difference

Conclusion: The lower MDI scores due to worse verbal abilities in the congenital gastrointestinal patient group needs to address this group as to be at risk with respect to language development. The significant lower MDI and PDI in surgical treated NEC patients demonstrate the stringent necessity of further systematic prospective research and longer follow-up for the patients.

 

 

 

Biography

 

Work:

Department of Paediatric Surgery and Paediatric Urology

University Hospital

Goethe-University Frankfurt/M.

 

Education

1979 – 1983

High School

1986 – 1992

Medical School

University of Leipzig, Leipzig, Germany

Graduation-Mark “summa cum laude”

12/1994

Doctor of Medicine

“Histological, immunohistochemical and polarisation-microscopical investigations of the collagen types within the anular radial ligament in children”

Reviewers for Doctor of Medicine

 

Professor Rainer Putz

Institute of Anatomy, University of Munich, Germany

 

Professor Wolfgang Schmidt

Institute of Anatomy, University of Leipzig, Germany

Professor Wolfgang Tischer

Department of Paediatric Surgery, University of Leipzig, Germany

 

02/2003

Thesis of Habilitation (similar to PhD)

“Histological, histochemical and immunohistochemical investigation of the innervation of the upper urinary tract in different animal models and human”

 

Reviewers for Thesis of Habilitation

 

Professor Katharina Spanel-Borowski

Institute of Anatomy, University of Leipzig, Germany

 

Professor Otto-Andreas Festge

Department of Paediatric Surgery, University of Greifswald, Germany

 

Professor Gerald Asmussen

Institute of Physiology, University of Leipzig, Germany