DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20181386

Burden and spectrum of neonatal surgical diseases in a tertiary hospital: a decade experience

Prashanth Madapura Virupakshappa, Nidhi Rajendra

Abstract


Background: Surgical emergencies in the newborns are an important and integral part of neonatal admissions in any tertiary Neonatal intensive care units. Surgical emergencies in the newborn constitute congenital anomalies and acquired neonatal emergencies. It is necessary to know the burden of these illnesses and their spectrum by regular auditing the data available to understand the relative incidence and outcome of these neonatal emergencies. Aims and objective of the study is to determine the spectrum of the different neonatal surgical emergencies (congenital and acquired) admitted, operated and managed in a tertiary NICU from June 2001 to May 2011(10 yrs) in a medical college teaching hospital in South India

Methods: The data was collected by retrospectively auditing the hospital pediatric and neonatal admission registry, neonatal surgical registry, admission case sheets from June 2001 to June 2011 (10 yrs). Data was analysed. Only confirmed post-operative surgical diagnosis were considered for inclusion in the study.

Results: Of the 13,118 newborns admitted in the NICU in 10 years, 601 cases (4.6%) were surgical neonates which were treated in the unit. 83.5% of surgical neonates were operated for congenital surgical disorders. Gastrointestinal anomalies (50%) were the leading causes of neonatal surgical emergencies. Anorectal malformations (18.5%), idiopathic hypertrophic pyloric stenosis (10.6%) and esophageal atresia with/without tracheo-esophageal fistula (8.7%) were the leading surgical causes which needed immediate surgical intervention in the newborn period. 28 different spectrum of cases were operated including 15 rarer once (<1% incidence each).

Conclusions: Surgical new-borns comprises of an important and integral part of neonatal admissions (4.6/100 neonatal admissions). The incidence of the rarer diseases constitutes 8% of the total surgical cases. Gastrointestinal anomalies are the leading causes requiring surgical interventions in the immediate newborn period. It is worthy to understand the spectrum of illnesses in any tertiary unit by regularly auditing the data available.


Keywords


Anorectal malformation, Congenital anomalies, Esophageal atresia, Neonatal surgery, Neural tube defects, Posterior urethral valve

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References


Gangopadhyay AN, Vijai DU, Sharma SP. Neonatal surgery: A Ten Year Audit from a University Hospital. Indian J Pediat. 2008;75:1025-30.

Shitaye N, Dejene B. Pattern and outcome of neonatal surgical cases at Tikur Anbessa University Teaching Hospital, Addis Ababa, Ethiopia. Ethiop Med J. 2016;54(4):213-20.

Sebastian OE, Obinna VA, Benedict CN. Neonatal surgery in Africa: a systematic review and meta-analysis of challenges of management and outcome. Avilable at: http://www.lancet.com. Accessed 27 April 2017.

Opara PI, Ujuanbi AS, Okoro PE. Surgical admissions in a newborn unit in a low resource setting, challenges in management and outcomes. J Neonatal Biol. 2014;3(2).

Saha AK, Ali MB, Biswas SK, Sharif HMZ, Azim A. Neonatal Intestinal obstruction: patterns, problems and outcome. Bangl Med J. 2012;45:6-10.

Yadav P, Mishra A, Raina VK. Neonatal Surgical Emergencies in a tertiary care center. IJSS J Surg. 2015;1(5)5-9.

Zalak S, Mitul K, Samir P, Yogesh P. Profile of congenital surgical anomalies in neonates admitted to tertiary care neonatal intensive care unit of Saurashtra region. Nat J Med Res. 2016;6(2)168-70.

Muhammad S, Hashem A, Isam EE, Fadi A. Pattern and outcome of neonatal surgery: Experience at King Fahad Hospital Al-Baha. PJMHS. 2014;8(2):262-67.

Dora C, Maria FL, Angel M, Barabara O, Antonia SC, Joaquim SV, Jose FN. Predictors of major postoperative complications in neonatal surgery. Rev Col Bras Cir. 2013;40(5):363-69.

Manish N, Jayashankar K, Arun KS, Faridi MMA. Predictors of Mortality among the neonates transported to referral centre in Delhi, India. Ind J Pub Health. 2013;57(2)100-4.

Amitabh R, Alka S. Pattern of morbidity and mortality of neonates admitted in tertiary level neonatal intensive care unit in Nalanda Medical College and Hospital, Patna, Bihar, India. Int J of Contemp Pediatr. 2016;3(3)854-57.

Awad RA, Selma HAK. Pattern of Neonatal surgical presentation and outcome in Sinar Hospital (2013-14). Global J Med Res. 2014;14(4):16-22.