Neonatal surgery

The scope and the problems of neonatal surgery are illustrated by reviewing a series of 1831 patients operated on over 15 years in one surgical unit. The patients were listed according the surgical subspeciality to which they belong (Tables 1--9). The results show that operative mortality is negligible in the good risk neonates (tumours, urology, orthopaedic and general surgery) but remains significant in the groups of serious malformations with high incidence of prematurity and associated anomalies. The present hospital mortality for patients with anorectal anomalies is about 5%, for spina bifida cystica about 10% and has even in oesophageal and duodenal atresia patients dropped to 15%. For other bowel atresias it is still 25% for gastroschisis and omphalocoele around 35% and for diaphragmatic hernia 50%. Cardiac surgery, including perfusion operations, has become an integral part of neonatal surgery, its present mortality being around 35%.