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PS05
LONG‐TERM OUTCOMES IN NEONATAL SURGERY
Author(s) -
Stringer M. D.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04125_5.x
Subject(s) - medicine , term (time) , quality of life (healthcare) , intensive care medicine , quality (philosophy) , life expectancy , outcome (game theory) , health care , pediatrics , nursing , environmental health , population , philosophy , physics , mathematical economics , epistemology , mathematics , quantum mechanics , economics , economic growth
Historically, for good reason, the main measures used to assess outcome after neonatal surgery have been mortality and early postoperative morbidity. These remain crucial yardsticks of surgical care. However, as results have steadily improved more refined indicators of outcome are needed. Long‐term results and quality of life outcomes are being demanded increasingly by clinicians, parents, and health economists. For paediatric surgeons, knowledge of long‐term outcomes not only enable us to inform parents and patients better about future health expectations but also help us to anticipate potentially avoidable late complications. Outcomes inform us when to operate and when not to operate. Some neonatal surgical conditions and their treatment have almost no long‐term sequelae but most have definite consequences of variable severity. Common themes run through the analysis of long‐term outcomes. These centre around the future impact on growth, risk of malignancy, psychological issues, implications for fertility, sexuality and inheritance, and quality of life. There are many reasons why long‐term data are lacking. These include the difficulties of maintaining long‐term surveillance within healthcare systems overstretched by lack of manpower and funding. Problems of continuity are exacerbated by geographic mobility in society. Robust long‐term studies require careful data collection over many years, the co‐operation of ex‐patients, and familiarity with tools such as independent quality of life measures not readily accessible to paediatric surgeons. Only by addressing long‐term outcomes will the true impact of neonatal surgical conditions be fully understood.