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Peer-reviewedCC BY-NC-ND 4.0BMC Pediatrics

What factors influence surgical decisions for post-NEC intestinal strictures in a 14-year, 325-case cohort?

  • Jinfeng Hou1
  • Qingshuang Liu1
  • Yi Wang1
  • Zhenhua Guo1
  • Wei Liu1
  • Shengde Wu2
  1. 1Department of General Surgery & Neonatal Surgery Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders,Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing Key Laboratory of Pediatrics, Chongqing, 401122, China
  2. 2Urology Department of Children’s Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Structural Birth Defect and Reconstruction, Chongqing Key Laboratory of Pediatrics, 20 Jinyu Avenue, Liangjiang New District, Chongqing, 401122 China
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Abstract

Objective: This study aimed to identify preoperative factors associated with stoma use in infants with post-NEC intestinal strictures and to develop a pragmatic model estimating the probability of staged stoma strategy selection.

Study design: A retrospective cohort of 325 infants who underwent surgery for NEC-related strictures at a single center (2010–2024) was analyzed. Preoperative variables were evaluated using LASSO logistic regression and multivariable modeling.

Results: Four independent predictors associated with stoma use were identified: hematochezia, elevated CRP (> 8 mg/L), higher preoperative WBC, and lower weight at surgery. The model demonstrated good discrimination (AUC 0.814), with temporal validation AUC of 0.779.

Conclusions: Preoperative inflammatory burden and lower weight at surgery were associated with stoma use in infants with post-NEC intestinal strictures. The model may support preoperative counseling and surgical planning, but should be interpreted as estimating the probability of stoma strategy selection in our institutional practice rather than defining objective indications for either stoma formation or primary anastomosis.

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Cite

BibTeXRIS
BibTeX
@article{hou2026what,
  title = {{What factors influence surgical decisions for post-NEC intestinal strictures in a 14-year, 325-case cohort?}},
  author = {Jinfeng Hou and Qingshuang Liu and Yi Wang and Zhenhua Guo and Wei Liu and Shengde Wu},
  journal = {BMC Pediatrics},
  year = {2026},
  month = jul,
  doi = {10.1186/s12887-026-07356-7},
  url = {https://doi.org/10.1186/s12887-026-07356-7},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - What factors influence surgical decisions for post-NEC intestinal strictures in a 14-year, 325-case cohort?
AU  - Jinfeng Hou
AU  - Qingshuang Liu
AU  - Yi Wang
AU  - Zhenhua Guo
AU  - Wei Liu
AU  - Shengde Wu
PY  - 2026
DA  - 2026/07/30
JO  - BMC Pediatrics
DO  - 10.1186/s12887-026-07356-7
UR  - https://doi.org/10.1186/s12887-026-07356-7
AB  - Objective: This study aimed to identify preoperative factors associated with stoma use in infants with post-NEC intestinal strictures and to develop a pragmatic model estimating the probability of staged stoma strategy selection.  Study design: A retrospective cohort of 325 infants who underwent surgery for NEC-related strictures at a single center (2010–2024) was analyzed. Preoperative variables were evaluated using LASSO logistic regression and multivariable modeling.  Results: Four independent predictors associated with stoma use were identified: hematochezia, elevated CRP (> 8 mg/L), higher preoperative WBC, and lower weight at surgery. The model demonstrated good discrimination (AUC 0.814), with temporal validation AUC of 0.779.  Conclusions: Preoperative inflammatory burden and lower weight at surgery were associated with stoma use in infants with post-NEC intestinal strictures. The model may support preoperative counseling and surgical planning, but should be interpreted as estimating the probability of stoma strategy selection in our institutional practice rather than defining objective indications for either stoma formation or primary anastomosis.
SN  - 1471-2431
ER  -