Prevention of Intestinal Atresia and Necrotizing Enterocolitis in Infants

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: closed (1 April 2025) | Viewed by 1188

Special Issue Editors


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Guest Editor
Paediatric Surgery, Department of Women’s and Children’s Health, Padova University Hospital, 35128 Padova, Italy
Interests: congenital abnormalities; neonatal surgery; necrotizing enterocolitis; colorectal diseases; microbiome; regenerative medicine; organoids

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Guest Editor
Paediatric Surgery, Department of Women’s and Children’s Health, Padova University Hospital, 35128 Padova, Italy
Interests: congenital abnormalities; stem cells; surgical gastroenterology; neonatal surgery; laparo-endoscopy surgery; pediatric urology

Special Issue Information

Dear Colleagues,

As Guest Editors of this Special Issue, entitled “Prevention of Intestinal Atresia and Necrotizing Enterocolitis in Infants”, it is with great pleasure that we invite you to submit your work to Children.

As we are all aware, the primary focus of mitigating the long-term adverse outcomes associated with intestinal atresia and necrotizing enterocolitis (NEC) lies in preventive measures. Specifically, novel surgical strategies aimed at reducing the incidence of short bowel syndrome (SBS) in intestinal atresia, alongside regenerative medicine approaches, have been proposed. Regarding NEC, global scientific efforts predominantly concentrate on prevention strategies, encompassing the identification of neonates at high risk for NEC, timely diagnosis, the manipulation of patients’ microbiota, and research efforts.

This Special Issue endeavors to compile and disseminate the latest clinical and research breakthroughs in preventing these conditions, which demand prompt and adept expertise from both pediatric and surgical domains.

Dr. Miriam Duci
Dr. Francesco Fascetti-Leon
Guest Editors

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Keywords

  • necrotizing enterocolitis
  • intestinal atresia
  • short bowel syndrome
  • artificial intelligence
  • regenerative medicine
  • microbiota

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Published Papers (2 papers)

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Research

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8 pages, 528 KiB  
Article
Small Intestinal Atresia: Should We Preserve the Peel or Toss It?
by Benedetta Marino, Giulia Mottadelli, Marta Bisol, Maria Sergio, Piergiorgio Gamba and Elisa Zambaiti
Children 2025, 12(2), 240; https://doi.org/10.3390/children12020240 - 17 Feb 2025
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Abstract
Background: Apple peel atresia (APA) is a rare and severe form of intestinal atresia, but little is known on long-term outcomes. We compared outcomes of apple-peel atresia based on different surgical approaches. Methods: a retrospective review from two institutions compared APA-resected and APA-preserved [...] Read more.
Background: Apple peel atresia (APA) is a rare and severe form of intestinal atresia, but little is known on long-term outcomes. We compared outcomes of apple-peel atresia based on different surgical approaches. Methods: a retrospective review from two institutions compared APA-resected and APA-preserved patients. Demographics, operative details, postoperative courses and long-term outcomes were analyzed. Results: Of the 16 APA neonates, 10 (62.5%) were in APA-resected and 6 (37.5%) in APA-preserved groups. Early postoperative complications occurred in 7 patients (43.75%) including vomiting, infection, intestinal occlusion, anastomotic dehiscence, multiorgan failure, equally distributed among groups. Length-of-stay is higher in the APA-preserved group (median 67 vs. 27 days, p = 0.14). Overall survival at discharge was 87.5%. Twelve children (75%) were followed for an average of 5 years. Reoperation was required in 4 children owing to anastomotic obstruction and adhesive intestinal obstruction, two in each group. Conclusion: to prevent intestinal failure, keeping the APA shows not inferior results compared to resection, even though it may have a longer first-postoperative course. Full article
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Review

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12 pages, 204 KiB  
Review
Advances in Artificial Intelligence and Machine Learning for Precision Medicine in Necrotizing Enterocolitis and Neonatal Sepsis: A State-of-the-Art Review
by Miriam Duci, Giovanna Verlato, Laura Moschino, Francesca Uccheddu and Francesco Fascetti-Leon
Children 2025, 12(4), 498; https://doi.org/10.3390/children12040498 - 13 Apr 2025
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Abstract
Necrotizing enterocolitis remains one of the most severe gastrointestinal diseases in neonates, particularly affecting preterm infants. It is characterized by intestinal inflammation and necrosis, with significant morbidity and mortality despite advancements in neonatal care. Recent advancements in artificial intelligence (AI) and machine learning [...] Read more.
Necrotizing enterocolitis remains one of the most severe gastrointestinal diseases in neonates, particularly affecting preterm infants. It is characterized by intestinal inflammation and necrosis, with significant morbidity and mortality despite advancements in neonatal care. Recent advancements in artificial intelligence (AI) and machine learning (ML) have shown potential in improving NEC prediction, early diagnosis, and management. A systematic search was conducted across multiple databases to explore the application of AI and ML in predicting NEC risk, diagnosing the condition at early stages, and optimizing treatment strategies.AI-based models demonstrated enhanced accuracy in NEC risk stratification compared to traditional clinical approaches. Machine learning algorithms identified novel biomarkers associated with disease onset and severity. Additionally, deep learning applied to medical imaging improved NEC diagnosis by detecting abnormalities earlier than conventional methods. The integration of AI and ML in NEC research provides promising insights into patient-specific risk assessment. However, challenges such as data heterogeneity, model interpretability, and the need for large-scale validation studies remain. Future research should focus on translating AI-driven findings into clinical practice, ensuring ethical considerations and regulatory compliance. Full article
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