TABLE 4.
Types of surgeries among VLBW delivery room survivors with T21, T18 and T13 in the Vermont Oxford Network born 2006–2009
| Group |
|||
|---|---|---|---|
| Type of Surgery1, N (%) | T21 N=653 |
T18‡ N=429 |
T13‡‡ N=131 |
| Open Heart or Vascular Procedures | 38 (5.8) | 3 (0.70) | 1 (0.76) |
| S502 Repair of coarctation of the aorta | 2 (0.31) | 1 (0.23) | -- |
| S504 Repair or palliation of congenital heart disease | 33 (5.1) | 2 (0.47) | 1 (0.76) |
| S500 Other open heart or vascular surgery requiring general or spinal anesthesia | 5 (0.77) | -- | -- |
| Abdomen | 137 (21.0) | 28 (6.5) | 7 (5.3) |
| S301 Rectal biopsy with or without anoscopy | 10 (1.5) | 1 (0.23) | -- |
| S302 Laparoscopy (diagnostic, with/without biopsy) | 3 (0.46) | -- | -- |
| S303 Laparotomy (diagnostic or exploratory, with/without biopsy) | 37 (5.7) | 2 (0.47) | 2 (1.5) |
| S304 Fundoplication | 10 (1.5) | 1 (0.23) | -- |
| S307 Jejunostomy, ileostomy, enterostomy, colostomy for intestinal diversion | 26 (4.0) | 2 (0.47) | 3 (2.3) |
| S308 Small bowel resection with or without primary anastomosis | 24 (3.7) | 2 (0.47) | 2 (1.5) |
| S309 Large bowel resection | 5 (0.77) | -- | -- |
| S310 Duodenal atresia/stenosis/web repair | 48 (7.4) | -- | -- |
| S312 Excision of Meckel’s diverticulum | 2 (0.31) | 1 (0.23) | 1 (0.76) |
| S313 Drainage of intra-abdominal abscess (not as primary treatment for NEC) | 1 (0.15) | -- | -- |
| S314 Surgery for meconium ileus | 2 (0.31) | 1 (0.23) | -- |
| S315 Excision of omphalomesenteric duct or duct remnant | 1 (0.15) | -- | -- |
| S317 Omphalocele repair (primary or staged) | -- | 1 (0.23) | 1 (0.76) |
| S318 Lysis of adhesions | 4 (0.61) | -- | -- |
| S319 Repair of imperforate anus (with or without vaginal, urethral, or vesicle fistula) | 2 (0.31) | -- | -- |
| S320 Pull through for Hirschsprung’s disease (any technique) | 2 (0.31) | -- | -- |
| S325 Repair of diaphragmatic hernia | 1 (0.15) | 2 (0.47) | -- |
| S327 Gastrostomy/jejunostomy tube | 48 (7.4) | 22 (5.1) | 1 (0.76) |
| S328 Upper endoscopy (stomach or duodenum, with or without biopsy) | 3 (0.46) | -- | -- |
| S329 Colonoscopy/sigmoidoscopy (with or without biopsy) | 1 (0.15) | -- | -- |
| S330 Takedown of ostomy and/or reanastomosis of bowel (small or large bowel)2 | 4 (0.77) | 1 (0.30) | -- |
| S331 Ladd’s or other procedure for correction of malrotation2 | 5 (0.97) | 1 (0.30) | -- |
| S332 Appendectomy2 | 10 (1.9) | 1 (0.30) | -- |
| S333 Primary peritoneal drainage for NEC, suspected NEC or intestinal perforation | 11 (1.7) | 1 (0.23) | 1 (0.76) |
| S336 Liver biopsy done during laparotomy or laparoscopy (includes wedge or needle techniques)3 | 1 (0.27) | -- | -- |
| S300 Other abdominal surgery requiring general or spinal anesthesia | 11 (1.7) | 1 (0.23) | -- |
| Thorax | 25 (3.8) | 11 (2.6) | 4 (3.1) |
| S201 Tracheal resection | 1 (0.15) | -- | -- |
| S203 Tracheoesophageal atresia and/or fistula repair | 6 (0.92) | 8 (1.9) | 1 (0.76) |
| S204 Thoracoscopy (with or without pleuridesis or pleurectomy) | 1 (0.15) | 1 (0.23) | -- |
| S205 Thoracotomy (with or without pleural or lung biopsy) | 3 (0.46) | 1 (0.23) | -- |
| S210 Bronchoscopy (with or without biopsy) | 18 (2.8) | 1 (0.23) | 1 (0.76) |
| S211 Esophagoscopy (with or without biopsy) | -- | -- | 1 (0.76) |
| S200 Other thoracic surgery requiring general or spinal anesthesia | 2 (0.31) | -- | 1 (0.76) |
| Genitourinary | 7 (1.1) | 4 (0.93) | 1 (0.76) |
| S410 Inguinal hernia repair | 7 (1.1) | 3 (0.70) | 1 (0.76) |
| S411 Orchiopexy | 1 (0.29) | -- | -- |
| S400 Other genitourinary surgery requiring general or spinal anesthesia | -- | 1 (0.23) | -- |
| Central Nervous System | 6 (0.92) | 2 (0.47) | -- |
| S901 Ventriculoperitoneal or other ventricular shunt | 4 (0.61) | 1 (0.23) | -- |
| S902 External ventricular drain | 1 (0.15) | -- | -- |
| S903 Ventricular drain with reservoir placement or removal | 2 (0.31) | -- | -- |
| S904 Meningocele or myelomeningocele repair | 1 (0.15) | 2 (0.47) | -- |
| S900 Other central nervous system surgery requiring general or spinal anesthesia | 1 (0.15) | -- | -- |
| Skin or soft tissue surgery requiring general or spinal anesthesia | 2 (0.31) | -- | -- |
| Head and Neck | 14 (2.1) | 6 (1.4) | 1 (0.76) |
| S101 Tracheostomy/Tracheotomy | 11 (1.7) | 5 (1.2) | 1 (0.76) |
| S103 Ophthalmologic surgery other than laser or cryosurgery for ROP | 2 (0.31) | -- | -- |
| S100 Other head and neck surgery requiring general or spinal anesthesia | 1 (0.15) | 1 (0.23) | -- |
| Diagnostic or Interventional Cardiac Catheterization | 10 (1.5) | 1 (0.23) | -- |
| S601 Diagnostic cardiac catheterization | 8 (1.2) | -- | -- |
| S602 Interventional catheterization with balloon septostomy | -- | 1 (0.23) | -- |
| S604 Interventional catheterization with pulmonary valvuloplasty | 1 (0.15) | -- | -- |
| S600 Other interventional catheterization whether or not anesthesia was required | 2 (0.31) | -- | -- |
| N=1515 | N=1106 | N=302 | |
| Any major surgery* | 453 (30.4) | 99 (9.2) | 19 (6.4) |
For a complete list of surgeries collected refer to the VON Manual of Operations. Numbers and frequencies shown in bolded font represent the number of infants with a certain surgery. Subheadings of surgeries represent the number of procedures. Example an infant with S303, S307 and S308 abdominal surgeries is included only once in bolded font and in each surgery category code accordingly.
Sugery specific codes added in 2006 unless otherwise stated.
Variable added in 2007.
Variable added in 2008.
Includes data collected from 1994–2009 on: infants with any of the above surgery codes (surgery specific codes added in 2006), NEC surgery, ROP surgery, surgical PDA ligation and infants with any major surgery conducted before the addition of the surgery specific codes in 2006. Surgeries S410 and S411 are not counted as major surgeries.
Infants with T18 and/or multiple procedures and/or open heart or vascular procedures included: 1 infant with S303, S307, S308, S312, S327, S330, S331, S332, S410, S101 and NEC surgery with an initial LOHS of 91 days, transferred to a non-VON center for other surgeries and was still hospitalized as of first birthday; infant with S502 procedure had a LOHS of 4 days and died; two infants with S504 procedure, 1 had a LOHS of 124 days and died and the second a LOHS of 103 days with missing data on discharge status; 1 infant with S327, S410, S101 with LOHS 303 days discharged alive.
Infants with T13 and and/or multiple procedures and/or open heart or vascular procedures included: 1 infant with S303, S307, S308, S210 and S101 with a LOHS of 66 days and died; 1 infant with S303, S307, S308, and S211 with a LOHS of 110 days discharged alive; 1 infant with S327 and S203 with a LOHS of 66 days and died; 1 infant with S504 procedure with a LOHS of 168 days discharged alive (also had PDA ligation).