ABSTRACT
Surgery for NEC is a challenge and is one of the most delicate operations that performed in the pediatric population. Given the high risk of potential surgical complications, as well as how sick these children can be, many surgeons will take a fatalistic approach, which becomes a self-fulfilling prophecy as the intestinal process worsens to the point of no return. However, with early intervention, experience teaches us that outcomes can be optimized. This chapter will focus on the five patterns of presentation of NEC that require surgery. By employing clearly defined indications for surgery, by adhering to well-accepted surgical principles (i.e., resection of necrotic tissue is required for survival), and by applying meticulous technique, this chapter will discuss how the lives of many children with NEC can be saved.
