2024 Volume 60 Issue 6 Pages 903-908
Purpose: In pediatric surgery, it is crucial to centralize and equalize care to ensure high-quality medical treatment, especially with the declining birth rate, leading to fewer cases. Given the limited number of pediatric surgeons in Okinawa Prefecture, it is essential to understand the current situation and determine suitable centralization and equalization strategies.
Methods: A questionnaire survey of 21 general hospitals in Okinawa Prefecture was conducted.
Results: Of the 17 facilities that responded, 11 performed from 530 to 800 pediatric surgical procedures annually. Eight facilities without pediatric surgery advocacy handled 80–250 cases per year. There was one board-certified pediatric surgical instructor and three board-certified pediatric surgeons at two facilities, whereas four surgeons with expertise in pediatric surgical practice were present at three facilities. Seven of the nine facilities without board-certified pediatric surgeons performed appendicitis and inguinal hernia surgeries that could be handled by surgeons with the knowledge of adult surgery, and two facilities also handled pediatric-surgery-specific diseases. All facilities agreed that pediatric surgical cases and pediatric surgeons should be centralized in a few facilities. Two facilities on remote islands requested the dispatch of pediatric surgeons.
Conclusion: Pediatric surgeons manage most diseases unique to children. Although the centralization of pediatric surgical care is widely recognized, adult surgical facilities treat diseases that can be handled by them. Centralization should be promoted gradually. Pediatric surgeons should be dispatched to general hospitals on remote islands to provide equal access to care. Therefore, securing pediatric surgeons is essential.
