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Cho, Kim, Lee, and Kim: Analysis of Neonatal Surgery during a 5-year Period
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2009; 77(6): 417-422.

Published online: 4 December 2009

DOI: https://doi.org/10.4174/jkss.2009.77.6.417

Analysis of Neonatal Surgery during a 5-year Period

Yonghoon Cho, M.D., Haeyoung Kim, M.D., Sanghyup Lee, M.D.1, Miran Kim, 1

Department of Pediatric Surgery, Pusan National University Children's Hospital, Busan, Korea.

1Department of Surgery, Pusan National University Yangsan Hospital, Postgraduate School of Medicine, Pusan National University, Busan, Korea.

Corresponding author (haeyoung@pusan.ac.kr)

Received 7 July 2009       Accepted 21 September 2009

Copyright © 2009 The Korean Surgical Society

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.

Keywords: Neonatal surgery, Collaborative care, Outcome

Figures and Tables

Fig. 1
Distribution of disease according to birth weight. ARMs = anorectal malformations; HD = Hirschsprung's disease; NEC = necrotizing enterocolitis; IHPS = infantile hypertrophic pyrolic stenosis; CDH = congenital diaphragmatic hernia; AWD = abdominal wall defect.
jkss-77-417-g001
Fig. 2
Comparison of postoperative results between separate and collaborative care groups.
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Table 1
Demography of surgical neonatal patients
jkss-77-417-i001

*ARMs = anorectal malformations; †HD = Hirschsprung's disease; ‡NEC = necrotizing enterocolitis; §IHPS = infantile hypertrophic pyrolic stenosis; ∥CDH = congenital diaphragmatic hernia; AWD = abdominal wall defect.

Table 2
Distribution of disease according to gestational age
jkss-77-417-i002

*ARMs = anorectal malformations; †HD = Hirschsprung's disease; ‡NEC = necrotizing enterocolitis; §IHPS = infantile hypertrophic pyrolic stenosis; ∥CDH = congenital diaphragmatic hernia; AWD = abdominal wall defect.

Table 3
Operative procedure during neonatal period
jkss-77-417-i003

*ARMs = anorectal malformations; †HD = Hirschsprung's disease; ‡NEC = necrotizing enterocolitis; §IHPS = infantile hypertrophic pyrolic stenosis; ∥CDH = congenital diaphragmatic hernia; AWD = abdominal wall defect.

Table 4
Associated anomalies according to diseases
jkss-77-417-i004

*ARMs = anorectal malformations; †HD = Hirschsprung's disease; ‡NEC = necrotizing enterocolitis; §IHPS = infantile hypertrophic pyrolic stenosis; ∥CDH = congenital diaphragmatic hernia; AWD = abdominal wall defect.

Table 5
Postoperative complications
jkss-77-417-i005

*ARMs = anorectal malformations; †NEC = necrotizing enterocolitis; ‡AWD = abdominal wall defect.

Table 6
Causes of death
jkss-77-417-i006

*ARMs = anorectal malformations; †NEC = necrotizing enterocolitis; ‡CDH = congenital diaphragmatic hernia; §AWD = abdominal wall defect.

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