Analysis of Neonatal Surgery during a 5-year Period

ABSTRACT

PURPOSE: In the field of pediatric surgery, neonatal surgery occupies a special portion and has clinical varieties. Recently many associated physicians, such as pediatric surgeons, neonatologists, anesthetists, pathologists and radiologists, work collaboratively for care. This study was designed to identify characteristics of neonatal surgery based on clinical experiences in a single institute. METHODS: Neonates receiving operation during a 5-year period between Jan. 2003 and Dec. 2007 in Pusan National University Children's Hospital were reviewed. Patients were divided into 2 groups of age after birth; early neonatal (before 7 days) and late neonatal period (after 7 days) and the operation was classified as a primary procedure for definite treatment and a staged procedure including 2nd look operation. We analyzed their clinical data and postoperative results. RESULTS: 286 cases of neonates were included during this period, 118 cases (41.3%) in early neonatal and 168 (58.7%) in late neonatal period. Distribution of diseases was as follows, sequentially; 60 (21.0%) anorectal malformations, 46 (16.1%) intestinal atresia, 44 (15.4%) Hirschsprung's disease, 35 (12.2%) necrotizing enterocolitis, 24 (8.3%) hypertrophic pyloric stenosis, 20 (6.9%) inguinal hernia, 13 (4.5%) malrotation, 9 (3.1%) tumor, 8 (2.7%) diaphragmatic hernia, 6 (2.0%) abdominal wall defect and 21 (7.3%) others. According to the operation, a primary procedure was performed in 205 cases (71.7%) and a staged procedure in 81 cases (28.3%). The morbidity and mortality was 3.1% and 2.8% respectively. CONCLUSION: When considering morbidity and mortality after neonatal surgery for patients who have associated anomalies, collaborative care is necessary to expect a good outcome.