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Gastrointestinal surgery in the neonate

机译：新生儿胃肠手术

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Summary The surgical treatment of neonates has enjoyed rapid development during the last 50 years. Neonatal surgery has now become an independent branch of general surgery, which requires the expertise of dedicated paediatric surgeons. Much of the development of neonatal surgery is due to the close collaboration between paediatric surgeons, neonatologists, anaesthetists, pathologists, radiologists, biochemists, and nurses. There has been a steady improvement in the outcome of most neonatal diseases requiring surgery. For example at Great Ormond Street Hospital for Children, London, the mortality for the most common congenital intestinal obstructions has declined from 50% in the 1950s and 1960s to 25% in the 1960s and 1970s to a current mortality of less than 5%. The reasons for this improvement can be ascribed to a better understanding of the physiology of surgical neonates, to the advances in fluid management, nutrition, mechanical ventilation, and not least to refinements in surgical techniques. There is still considerable work to be done to improve the survival of neonates with severe conditions such as necrotizing enterocolitis (NEC). Surgery of the gastro-intestinal tract is required for congenital abnormalities and acquired lesions. In this article the authors focus on the most common congenital anomalies of the gastro-intestinal tract requiring surgery. In addition they discuss two acquired conditions requiring surgery in neonates: NEC and hypertrophic pyloric stenosis. It is beyond the scope of this article to discuss anomalies of the abdominal wall, gastro-oesophageal reflux, and anomalies of the pancreato-biliary system.
机译：总结在过去的50年中，新生儿的外科治疗得到了快速发展。新生儿外科现已成为普通外科的一个独立分支，这需要专门的儿科外科医生的专业知识。新生儿外科手术的发展很大程度上归功于儿科医生，新生儿科医生，麻醉师，病理学家，放射线学家，生物化学家和护士之间的密切合作。大多数需要手术的新生儿疾病的治疗效果一直在稳步提高。例如，在伦敦的大奥蒙德街儿童医院，最常见的先天性肠梗阻的死亡率已从1950年代和1960年代的50％下降到1960年代和1970年代的25％，降至目前的不到5％。这种改善的原因可以归因于对手术新生儿的生理的更好理解，流体管理，营养，机械通气方面的进步，尤其是对外科技术的改进。要改善患有坏死性小肠结肠炎（NEC）等严重疾病的新生儿的存活率，还有许多工作要做。先天性异常和后天性病变需要胃肠道手术。在本文中，作者着眼于需要手术的最常见的先天性胃肠道异常。此外，他们讨论了新生儿需要手术的两种获得性疾病：NEC和肥大性幽门狭窄。讨论腹壁异常，胃食管反流和胰胆系统异常不属于本文的讨论范围。

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