Vol. 36, pp , 2008

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1 235 Vol. 36, pp , : : p ,500 g 1500 g 31.7 vs 3.6, P

2 236 Table 1. Clinical Data of Neonates with Surgical Disorders Esophageal atresia: 2 Bowel atresiastenosis: 3 Hypertrophic pyloric stenosis: 30 4 Malrotation of the intestine: 5 Hirschsprung Hirschsprung s disease and allied disorders 6 Meconium-related obstruction: 7 Anorectal anomalies: 8 Bowel perforation: 9 Abdominal wall defects: 10 Diaphragmatic hernia: Bochdalek 10 11: 12: 13: 38

3 Fig. 1. Case number of neonates and total inpatients per 5-year study period : , , , , Ryan P0.05 1: : Table Fig 1 2: g g1000 g Table 1 3: Hirschsprung Fig ;

4 238 Fig. 2. Distribution of major neonatal surgical disorders : Table : Table p Fig ; p0.01 Fig

5 Fig. 3. Mortality rates for surgical neonates per 5-year study period. Fig. 4. Mortality rates for neonates with major surgical disorders DIC 4 Table g g g 1500 g p0.01; Fig

6 240 Table 2. Causes of Death of Neonates with High Mortality Rate Fig. 5. Comparison of mortality for surgical neonates according to birth weight Hirschsprung Quality of life QOL 42

7 Table g 1500 g Extrauterine intrapartum treatment; EXIT Kramer MS, Liu S, Luo Z, Yuan H, Platt RW and Joseph KS. Analysis of perinatal mortality and its components: time for a change? Am J Epidemiol 2002; 156: ; 40: ; 108: Lakhoo K. Fetal councelling for congenital 43

8 242 malformations. Pediatr Surg Int 2007; 23: ; 108: Murph FL, Mazlan TA, Tarheen F, Corbally MT and Puri P. Gastroschisis and exomphalos in Ireland Does antenatal diagnosis impact on outcome? Pediatr Surg Int 2007; 23: ; 42: RI 2005; 41; ; 41: ; 108: ; 15: ; 26: ; 19: Chang AC, Hanley FL, Lock JE, Castaneda AR and Wessel DL. Management and outcome of low birth weight neonates with congenital heart disease. J Pediatr 1994; 124:

9 Abstract RESULTS OF SURGICAL TREATMENT GIVEN TO NEONATES IN A SINGLE INSTITUTION: A 25-year analysis of 643 patients Hiroaki Kitagawa, Takeshi Aoba, Yasuji Seki, Munechika Wakisaka, Yoshitaka Kim, Misao Ishikawa, Teruhiro Fujioka, Tomotake Enami, Mikio Kuwahara, Fumio Kawaguchi, and Koonosuke Nakada. We evaluated the results of treatment in 643 neonates with various surgical disorders experienced during the past 25 years from April 1982 to March Of 643 neonatal patients, 321 patients roughly 50 were diagnosed on the first day of life, within a week, within 2 weeks, and more than 2 weeks after birth. Among them, 363 patients 57 underwent surgery within 30 days after birth. Sixty-two 9.6 patients died during the initial hospital stay. The mortality rate for the patients in the initial 5-year study period was 20 which was significantly decreased to 5.6 for the patients in the most recent 5 -year study period p0.05. The mortality rate for patients with diaphragmatic hernia was 44.8, which was the highest mortality among patients with major diseases, followed by patients with bowel perforation 27.7, abdominal defects 19.8, and esophageal atresia The mortality rate for low-birth weight 1500 g infants was significantly higher than for the higher-birth weight 1500 g infants 31.6 vs. 3.6, p Thus the outcome of the surgical neonates treated in our institution improved steadily throughout each 5-year study period. However, mortality for neonates with diaphragmatic hernia, abdominal wall defects, and bowel perforation remain high, because of recent increase of severe premature patients, chromosomal abnormalities combined with severe anomalies, and prenatally diagnosed more severe disorders. Key Words neonate, surgical disorders, treatment results, neonatal surgery, fetal surgery Division of Pediatric Surgery, St. Marianna University School of Medicine Kawasaki, Japan 45

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Number All 397 Women 323 (81%) Men 74 (19%) Age(years) 39,1 (17-74) 38,9 (17-74) 40,5 (18-61) Maximum known weight(kg) 145,4 (92,0-292,0) 138,9 (92,0-202,0) 174,1 (126,0-292,0) Body mass index (kg/m 2