Spectrum of paediatric surgical cases and their outcome in tertiary care hospital

Pediatric surgical cases and their outcome

Abstract

Introduction: Pediatric surgical cases are operated by general surgeon due to lack of pediatric surgeons. Complex cases in neonates and infants is being referred to other centers with pediatric surgical services. This study aims to compare the spectrum of pediatric surgical cases and their outcomes before and after the availability of pediatric surgeon.

Method: This retrospective study was conducted at the Patan Hospital, Nepal, over a period of 4 years. Group 1 (G1) included surgeries during 1^st 2 y before and Group 2 (G2) during 2^nd 2 y period after the availability of pediatric surgeon. Ethical approval was obtained. Patient age, sex, diagnosis, operative procedure, type of surgery, and outcome were analyzed. 

Result: Of 1157 cases, 369 were in G1 and 788 in G2. The male to female ratio was 2.8:1. Laparotomies 270(23.2%) was the most performed inpatient surgery and herniotomies (221(19.1%) in day care. There were 52 (4.5%) neonates; 2(4%) in G1 and 50(96%) in G2. Among total cases, the mortality rate was 8(0.7%) in G2, due to preterm birth, delayed presentation, and septicemia.

Conclusion: Laparotomy and incision & drainage were the most commonly performed surgeries. There was a 96% increment in neonatal cases (50 v/s 2) after the availability of pediatric surgeon. Mortality was 8(0.7%) in group-2 due to delayed presentation and septicemia.

Keywords: Daycare surgery, mortality, neonatal surgery, outcome, pediatric surgical services