A Clinical Analysis of Neonatal Surgical Diseases

A clinical analysis of the surgically managed neonatal surgical diseases was made with 92 patients under 4 weeks old who were admitted during 12 years period from Jan. 1976 to Dec. 1987. And the outcome of the first half period was compaired with that of the second half period. The results were as follows. 1) Pediatric surgical patients were 17.6% of total patients admitted in the department of the general surgery, and 4.6% of these (92 cases) were neonatal surgical patients. The number of neonatal surgical patients were increased significantly during the second half period. 2) 69 cases were male and 23 cases were female. A ratio of male to female was 3:1. 3) About 60% of the cases were admitted during their first week of life and there were 30% of the cases who admitted during the last week of their neonatal period. 4) Except three cases, 89 cases (96.7%) were admitted with congenital surgical anomalies. 5) More frequent diseases were as follows: congenital hypertrophic pyloric stenosis ; 24 cases (26.1%), jejuno-ileal atresia or stenosis ; 13 cases(14.1%), imperforate anus; 13 cases (14.1%) and congenital duodenal obstruction; 11 cases(11.1%). 6) Vomiting was the main symptom to three quarters of the cases. 7) The number of cases associated with the other congenital anomalies were 14 cases(15.7%). 8) The postoperative complication rate was equally 26% during the first half (9/35) and the second half period (15/57), and the frequent complications were the respiratory problems, sepsis, and wound complications. 9) The mortalities were 28.6% (10/35) during the first half and 8.8% (5/57) during the second half period. Better understanding of neonatal physiology, adequate attention, and active management of pre- and postoperative neonates have certainly contributed to the increased survival during the second half period.