Evidence map›Paper›PMID 41037119›Full record

ArticlePediatric surgery international2025

Initiation of oral intake in neonates with surgical necrotizing enterocolitis: a road map.

Mazen Omar Kurdi, Mohamed Ali Shehata, Nagi Ibrahim Eldessouki, Ahmed Mukhtar, Heidi Al-Wassia, Maha Bamehrez, Mohammad Gharieb Khirallah

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Mazen Omar KurdiPediatric Surgery Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Mohamed Ali ShehataDepartment of General Surgery, Pediatric Surgery Unit, Faculty of Medicine, Tanta University, Tanta University Hospitals, El-Geish Street, Tanta, 31257, Egypt. Mohamedshehata81@hotmail.com.ORCID http://orcid.org/0000-0003-3913-1836
Nagi Ibrahim EldessoukiDepartment of General Surgery, Pediatric Surgery Unit, Faculty of Medicine, Tanta University, Tanta University Hospitals, El-Geish Street, Tanta, 31257, Egypt.
Ahmed MukhtarPediatric Surgery Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Heidi Al-WassiaPediatric Department, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Maha BamehrezPediatric Department, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.
Mohammad Gharieb KhirallahDepartment of General Surgery, Pediatric Surgery Unit, Faculty of Medicine, Tanta University, Tanta University Hospitals, El-Geish Street, Tanta, 31257, Egypt. Mohamed.khirallah@med.tanta.edu.eg.ORCID http://orcid.org/0000-0003-4261-7474

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeNecrotizing enterocolitis (NEC) is a severely life-threatening gastrointestinal emergency in newborns, especially when surgical intervention is needed. The ideal time for resuming oral feeding after surgery is still unclear, leading to variations in practice and prolonged parenteral nutrition. This study aims to develop and validate a scoring system to determine the best time to reintroduce oral feeding in neonates following surgical NEC.

methodsA multicenter retrospective study was conducted from 2016 to 2024, including 500 neonates with surgical NEC (Bell's Stage III-IV). Patients were divided into early (5 days), intermediate (8-14 days), and delayed (≥ 15 days) feeding groups. A predictive score was constructed on 100 patients using eight preoperative, intraoperative, and postoperative variables. Validation was performed on an independent cohort of 400 patients.

resultsThe scoring system demonstrated strong predictive accuracy (AUC = 0.967). Variables such as localized pneumatosis, absence of portal venous gas, higher platelet count, no second-look laparotomy, and early normalization of nasogastric aspirates and lab parameters were significantly associated with early feeding tolerance (p < 0.05). Validation confirmed reproducibility across cohorts without NEC recurrence or feeding-related complications.

conclusionWe present a validated, clinically practical scoring system to guide early oral intake initiation after NEC surgery. It enables stratified decision-making, reduces reliance on parenteral nutrition, and enhances postoperative recovery.

Indexed as

EatingEnteral NutritionEnterocolitis, NecrotizingFemaleHumansInfant, NewbornMaleReproducibility of ResultsRetrospective StudiesEnteral feedingIntestinal recoveryNecrotizing enterocolitisNeonatal surgeryPostoperative nutritionPredictive modelPreterm infantsScoring system

Identifiers

PMID41037119

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.