Challenges and Outcome of Neonatal Surgeries in a Teaching Hospital in Enugu, Nigeria

BACKGROUND: The outcome of neonatal surgery is a measure of the quality of pediatric surgery services in any center. The outcome of treatment is still relatively poor in developing countries.
This study aimed to evaluate our experience and the challenges we encountered in the management of surgical neonates.
METHODS: This was a retrospective study of neonates that had surgery at the pediatric surgery unit of Enugu State University Hospital, Enugu, Nigeria. Medical records of neonates that had surgery over a 5-year period were evaluated.
RESULTS: There were 30 cases of neonatal surgeries with an age range of 2-20 days (median 10.8 days) at presentation and male to female ratio of 2.3:1. The median duration of symptoms prior to presentation to the hospital was 3 days (range: 1–12). Most of the neonates were delivered in a health center. Necrotizing enterocolitis was the most common diagnosis in neonates. Colostomy creation and insertion of peritoneal drain were the most performed surgical procedures in the neonates. Surgical site infection was the most common postoperative complication. Mortality was 36.7%.
CONCLUSION: The outcome of neonatal surgeries in our center is still poor and is fraught with several challenges. Early presentation, provision of well-equipped neonatal intensive care unit and availability of parenteral nutrition are required to improve outcome.