Does the timing of surgery affect short-term prognosis in newborn infants with meningomyelocele?

Objective: To investigate the effect of postnatal primary repair surgery time on short-term (first 30 days) prognosis in newborns with Meningomyelocele (MMC).

Methods: The study was conducted in the neonatal intensive care unit at a tertiary training and research hospital. The records of 41 MMC neonates were retrospectively reviewed. Demographic and clinical characteristics, surgical time, hospitalization and antibiotic duration, complications and associated anomalies were recorded.

Results: There were 18 newborns in the early surgery (≤3 days) group and 23 newborns in the late surgery (>3 days up to 30 days) group.. There was no difference between groups in terms of birth weight, gestational week, head circumference, sex and type of delivery (p > 0.05). The length of hospitalization (17.2 ± 8.2 days vs 24.8 ± 16.1 days, p > 0.05) and antibiotic duration (11.8 ± 7.6 days vs 13.8 ± 10.1 days, p > 0.05) did not have significant difference. The number of neonates reoperated in the first 30 days was similar in early surgery group and in late surgery group (5 (27.7%) vs 6 (26.1%), p > 0.05). The number of patients requiring ventriculoperitoneal shunt was 9 (50%) in the early surgery group and 13 (56.5%) in the late surgery group. Surgical complications such as minor-major wound dehiscence, cerebrospinal fluid leakage, local infection, meningitis and ventriculitis were not statistically different between the groups (9 (50%) vs 8 (34.8%), (p > 0.05).

Conclusion: Surgical complications were not statistically different between the early and late surgery group, although the presence of surgical complications may be effective in the short-term prognosis of MMC.