Incidence and clinical outcomes of postoperative small bowel obstruction after neonatal abdominal surgery: a single-center retrospective study.

PURPOSE: The long-term incidence and clinical course of neonatal abdominal surgery remain unclear. We evaluated the incidence, management, and outcomes of postoperative SBO following neonatal abdominal surgery.

METHODS

We retrospectively reviewed the records of neonates who underwent abdominal surgery within 30 days of birth in 2000-2025. Patients with postoperative SBO were identified, and their clinical characteristics, treatment, and outcomes were analyzed. The cumulative incidence was estimated using a competing risk analysis, with death before SBO treated as a competing event.

RESULTS

Among 312 neonates, 19 (6.1%) developed postoperative SBO, with 29 SBO events. The median interval from the initial surgery to the first SBO was 10.9 months, and 11 patients (57.9%) developed SBO within 1 year. During the first SBO episode, surgical intervention was required in 10 patients (52.6%). Bowel resection was required in 4 (21.1%). Seven patients developed recurrence (36.8%). No deaths occurred during SBO treatment. The cumulative incidence at 1, 5, 10, and 20 years was 4.6%, 7.3%, 8.1%, and 13.2%, respectively.

CONCLUSION

SBO after neonatal abdominal surgery frequently occurs within 1 year, but the risk persists for a long time. The high surgical intervention and recurrence rates support its importance as a long-term complication of after neonatal abdominal surgery.