[Trends in neonatal surgery in Japan]

A nationwide survey on neonatal surgery is conducted every five years by the Japanese Society of Pediatric Surgeons. The first survey was in 1964, and the most recent was in 2003. Three thousands seven hundreds and nine cases were collected in 2003. The number of newborns undergoing surgical management had increased substantially, in spite of a gradual decline in the annual birth rate for more than three decades. The overall mortality rate for newborns having surgery had improved to 9.0% in 2003, down from 32% in 1968. Intestinal perforations showed the worst mortality rate of 31.6%, probably due to an increment in the rate of low birth-weight babies. The mortality rate of Bochdalek hernias had been improving gradually and achieved 25.4%. Esophageal atresias and omphaloceles, which are frequently associated severe anomalies, had a mortality rate of more than 10%. The management of low birth-weight babies and of severe complicated anomalies should be improved.