Twenty-year trends in neonatal surgery based on a nationwide Japanese surveillance program

Yagi, Minoru; Kohno, Miyuki; Asagiri, K.; Ikeda, Taro; Okada, Tadao; Kanada, Satoshi; Kawashima, Shuji; Goto, Yasutomo; Takano, Shuichi; Yasufuku, Masao; Motoshi, Wada

doi:10.1007/s00383-015-3775-z

Cited by 25 publications

(24 citation statements)

References 12 publications

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“…Although this compares with the overall trend reported across Africa, it is still more than double the projected SDG 3.2 target and much higher when compared to less than 5% reported in high-income countries. [15] Comparing different systems, gastrointestinal pathologies contributed to the overwhelming majority (76, 93.8%) of the mortalities in the present report of general pediatric surgical neonates. Most mortalities were from surgery for intestinal atresias, gastroschisis, esophageal atresia, omphalocele, anorectal malformation, and intestinal malrotation, similar to previous single institutional reports from Nigeria and Africa, [16,17] but much higher than HICs.…”

Section: Mortalitymentioning

confidence: 66%

Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

et al. 2022

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Background: Despite a decreasing global neonatal mortality, the rate in sub-Saharan Africa is still high. The contribution and the burden of surgical illness to this high mortality rate have not been fully ascertained. This study is performed to determine the overall and disease-specific mortality and morbidity rates following neonatal surgeries; and the pre, intra, and post-operative factors affecting these outcomes. Methods: This was a prospective observational cohort study; a country-wide, multi-center observational study of neonatal surgeries in 17 tertiary hospitals in Nigeria. The participants were 304 neonates that had surgery within 28 days of life. The primary outcome measure was 30-day postoperative mortality and the secondary outcome measure was 30-day postoperative complication rates. Results: There were 200 (65.8%) boys and 104 (34.2%) girls, aged 1-28 days (mean of 12.1 ± 10.1 days) and 99(31.6%) were preterm. Sepsis was the most frequent major postoperative complication occurring in 97(32%) neonates. Others were surgical site infection (88, 29.2%) and malnutrition (76, 25.2%). Mortality occurred in 81 (26.6%) neonates. Case-specific mortalities were: gastroschisis (14, 58.3%), esophageal atresia (13, 56.5%) and intestinal atresia (25, 37.2%). Complications significantly correlated with 30-day mortality (p <0.05). The major risk predictors of mortality were apnea (OR=10.8), severe malnutrition (OR =6.9), sepsis (OR =7. I), deep surgical site infection (OR=3.5), and re-operation (OR=2.9). Conclusion: Neonatal surgical mortality is high at 26.2%. Significant mortality risk factors include prematurity, apnea, malnutrition, and sepsis.

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Section: Mortalitymentioning

confidence: 66%

Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

et al. 2022

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“…On the contrary, neonatal mortality in a report from Australia was 3.6% over 16 years [11]. In Japan, mortality linearly declined from 12% in 1993 to 6.6% in 2013 [12]. In a large study from South Korea, neonatal surgical mortality was 6.7% [13].…”

Section: Discussionmentioning

confidence: 93%

Mortality from Surgical Conditions in Children: An Insight from a Tertiary-Level Government Hospital in Bangladesh

Chowdhury

Kabir²,

Farooq

et al. 2020

AJPR

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Aims: While the developed world has significantly reduced mortality from surgical conditions in children, there is lack of adequate data on the outcome of children’s surgical conditions in the developing world. This study aims at assessing the spectrum of mortalities from children’s surgical conditions in a low-middle income country (LMIC). Methods: Mortality data were collected for a period of 12 years (2008 to 2019) among 0 to12-year old children to analyse the diseases which had higher mortality trends, age -group specific mortality trends and categorize those according to body system. Results: Among a total of 30,301 admitted children, 1228 (4.05%) patients died. Among them 53.01% were neonates, 20.28% were infants and 26.71% were children. Male to female ratio was 1.95:1. Mortality from neonatal surgical conditions was 24.21%. Infant mortality rate was 5.65% and child mortality rate was 1.41%. Neonatal surgical admission and mortality had a higher yearly trend. Anorectal malformation (ARM) was the most common cause of death (12.05%), followed by intestinal obstruction (11.40%) and gastroschisis (8.63%). Tracheo-oesophageal fistula/ oesophageal atresia (TOF/OA) had the highest mortality rate (83.33%), followed by gastroschisis (80.92%) and intestinal atresia (42.535) among the respective admissions. Other important causes of mortality were jejuno-ileal atresia (5.37%), trauma (5.05%), Hirschsprung disease (4.64%), intestinal perforation (4.48%), omphalocele (4.15%), burn (4.07%) and posterior urethral valves (PUV), 3.58%. Conclusion: Overall mortality rate was much higher than developed countries and lower than some African countries. Neonatal mortality rate was very high and among them TOF/OA and gastroschisis had extremely high mortality rates.

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“…Neonatal general surgical mortality has significantly improved globally in the last three decades. [1][2][3] Ad-vancements in neonatal intensive care, anesthesia, nursing, and medical technology have transformed the outcomes in all babies, including preterm babies.…”

Section: Discussionmentioning

confidence: 99%

Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development

Khalil

Zarroug²,

Elawad³

et al. 2021

J Neonatal Surg

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Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region. Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 – 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded. Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %. Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations.

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Twenty-year trends in neonatal surgery based on a nationwide Japanese surveillance program

Abstract: The present findings may be the result of remarkable progress in perinatal management.

Cited by 25 publications

References 12 publications

Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

Burden and outcome of neonatal surgical conditions in Nigeria: A countrywide multicenter cohort study

Mortality from Surgical Conditions in Children: An Insight from a Tertiary-Level Government Hospital in Bangladesh

Outcomes following the establishment of Qatar’s quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development

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