Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Where should paediatric surgery be performed?

G S Arul1, R D Spicer

  • 1Department of Paediatric Surgery, Bristol Royal Hospital for Sick Children, UK.

Archives of Disease in Childhood
|October 15, 1998
PubMed
Summary
This summary is machine-generated.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Perioperative management of tracheo-oesophageal fistula and oesophageal atresia.

BJA education·2025
Same author

Outcomes of patients with exomphalos and associated congenital heart diseases.

Pediatric surgery international·2022
Same author

Getting it right first time: implementation of laparoscopic pyloromyotomy without a learning curve.

Annals of the Royal College of Surgeons of England·2021
Same author

Congenital mesoblastic nephroma: a single-centre series.

Annals of the Royal College of Surgeons of England·2019
Same author

Common goals, shared risk and a just culture: human factors lessons from the front line.

Journal of the Royal Society of Medicine·2017
Same author

Human factors in decision making in major trauma in Camp Bastion, Afghanistan.

Annals of the Royal College of Surgeons of England·2015

Centralizing pediatric surgical care in specialist centers improves outcomes, despite challenges with travel. Evidence shows better results in high-volume centers for neonatal surgery and complex cases.

Area of Science:

  • Paediatric Surgery
  • Healthcare Organisation
  • Surgical Outcomes

Background:

  • Debate exists regarding the optimal organisation of paediatric surgical care, with limited data from district general hospitals.
  • Healthcare reorganisation necessitates a clear understanding of issues surrounding specialist paediatric centres versus district general hospital provision.
  • Anecdotal evidence often forms the basis of discussions on surgical management of children.

Purpose of the Study:

  • To review evidence on the organisation of paediatric surgical care.
  • To discuss the roles of specialist paediatric centres and non-specialist provision in district general hospitals.
  • To evaluate the benefits and disadvantages of centralising paediatric surgical services.

Main Methods:

  • Review of published data and existing evidence on paediatric surgical care organisation.

Related Experiment Videos

  • Analysis of arguments for and against large regional specialist paediatric centres.
  • Examination of data from centralised versus decentralised paediatric intensive care units.

    • Main Results:

    • Centralisation benefits include concentrated expertise, improved on-call commitment, enhanced support services, and better junior doctor training.
    • Disadvantages of centralisation involve increased travel distances for families and potential loss of local expertise.
    • Centralised paediatric intensive care units demonstrate lower mortality rates compared to decentralised models, especially when specialist transport is available.
    • Clear evidence supports specialist-led neonatal surgery and anaesthesia.
    • Lower procedure volumes correlate with worse outcomes in neonatal surgery, oncology, radiology, pathology, and intensive care.

    Conclusions:

    • The benefits of centralising paediatric surgical care, particularly for complex and neonatal cases, outweigh the drawbacks when supported by appropriate infrastructure like specialist transport.
    • Maintaining specialist status requires a sufficient 'critical mass' of complex surgical cases to ensure clinical effectiveness and support ancillary services.
    • Organised paediatric surgical care requires recognition of the unique needs of neonates and children, necessitating specialist expertise and multidisciplinary approaches.