Neonatal surgery is the special field in pediatric surgery, and it has been known as a standard when evaluate the pediatric surgery activity. Neonatal surgery in South Korea has been remarkably progressed as the socioeconomic condition is
improved. We
investigated spectrum of neonatal surgery in 1989.
Total numbers of neonatal surgery performed by 28 pediatric surgeons are about 450 cases (0.6/1,000 birth) throughout the study period. Most common diseases gastrointestinal anomaly (71.8%), followed by abdominal wall defect(17.2%), thoracic
anomaly(6.7%). Pyloric stenosis is the most common among gastrointestinal diseases. Common diseases observed in neonatal surgery are pyloric stenosis(21.1%), anorectal malformation(14.1%), Hirschsprung's disease(9.7%), and jejunoileal
atresia(9.0%)
in
order of frequency.
Overall postoperative mortality is 12.9%, and idiopathic gastric perforation showed the highest rate(58.3%) and gastroschisis(49.2%), meconium peritonitis(40%), congenital diaphragmatic hernia(39.4%), tracheoesophageal fistula(32.6%),
omphalocele(31.3%)
were followed. Most common caused postoperative death were respiratory failure(46.4%) and sepsis(40.1%).
Combined anomalies were observed in 79 cases(7.4%) and gastrointestinal anomalies(48.1%), cardiac anomalies were common. In case of combined anomalies, the mortality is exceedingly higher(41.8%) than average and it is highest in case with
congenital
diaphragmatic hernia(30.3%).
The current status of neonatal surgery in South Korea is not so good as in well established countries. The main problems are in shortage of staff, medical equipment, and economic problem.
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