NEONATAL SURGERY
Neonatal surgery has made tremendous progress in last two decades and the outcome of surgical intervention is far better than it used to be. The collaboration between pediatrician and pediatric surgeon is very important in the case of a newborn particularly preterm and term low birth weight babies, where temperature regulation, fluid balance, assessment of metabolic disturbances, respiratory function, management of nutrition etc are vital for a successful outcome. Not only is a joint evaluation valuable for assessing the neonate prior to surgery, but also in the management of the neonate afterwards.
Pediatricians and neonatologists are the first contact for any ailment of the neonate, whether it is medical or surgical. Extensive information in the form of text books, short books, hand books etc. is available for medical conditions. But the information regarding common surgical conditions in neonates is woefully inadequate. Whatever available is either brief description in the textbooks of neonatology and pediatrics or too extensive authoritative narration in the text books of pediatric surgery. Therefore, this issue of Journal of Neonatology has been planned to suit the requirements of pediatricians and neonatologists engaged in the care of neonates.
The contributors of this issue are experienced pediatricians and pediatric surgeon, who have made the description and management very simple and relevant to Indian perspective. This issue will be a valuable reading not only for neonatologists but also for pediatricians who are usually the first contact for the family in need of advice for neonate.
Congenital malformations have gradually increased in importance as a cause of perinatal and neonatal mortality. Intent and purpose of neonatal surgery is the surgery of congenital malformations. It is therefore important to know something about the frequency of malformations their etiology and the risk of the same defect occurring in subsequent pregnancies. Not all congenital lesions need to be addressed to immediately. While some constitute dire emergencies others are dealt with after initial stabilization, still others have their specific unique optimal time zones for ideal management. Recognition of these will help both the referring neonatologist/pediatricians and the surgeon and ultimately translate into better overall management of the patient.
Initial management of anorectal malformations and its subsequent reconstructive work constitute a large part of the Pediatric surgical practice. It then is prudent that the spectrum of lesion is appropriately recognized and promptly treated. It also is important that the clinician getting in touch with the patient at the outset knows about this condition and its reasonable outcome, so as to appraise the parent appropriately.
There are myriad causes of vomiting in neonates but when is this due to a surgical cause? Similarly jaundice when to suspect it to be surgical and call our surgical colleague has always been the challenge for the treating pediatrician. Effort has been made to resolve some of the issues.
This issue of Journal of Neonatology is not inclusive of all areas related to neonatal surgery. Some of them will be covered in the subsequent issues as neonatal surgery in a very broad area. It is hoped that articles included in this issue will help in better understanding and outcome of neonatal surgeries.
