In order to clarify the current status of regionalization for surgical newborns, patients born in Aichi Prefecture from January to December 2000 were investigated using a questionnaire Two-hundred-and-twenty-two newborns were registered including 46 cases of imperforated anus, 22 cases of diaphragmatic hernia, 14 cases of esophageal atresia and so on. An antenatal diagnosis was made for 55 cases (241%). Of those, 6 cases were interrupted, 15 cases of diaphragmatic hernia were included, and 24 cases were followed by maternal transport The overall mortality was 10.4% Regionalization of neonatal surgery in this area has been completely established, and 92.4% of all cases were managed by pediatnc surgeons certified by the Japanese Society of Pediatnc Surgeons.
This report addresses the present state of the regionalization of pediatric surgery in Japan, with specific reference to one particular area, Kagoshima Prefecture in Southern Kyushu. The number of pediatric surgical cases was estimated to be about 1800 in the fiscal year of 1995 Of these cases, 515 underwent surgery in two institutions with full-time pediatric surgeons and about 100 cases underwent surgery in medical association hospitals with part-time pediatric surgeons. In Kagoshima Prefecture, there are only two facilities where neonatal surgery can be performed and almost all neonatal surgery is earned out in these facilities Pediatric surgeons generally operate on most of the infants and young children However, general surgeons perform surgery on school children and junior high school students Operative procedures by general surgeons are limited to inguinal hernorraphy or appendectomy. At the present time, in Kagoshima Prefecture, it is impossible and impractical to treat all pediatric patients in the pediatric surgical institutes. For regionalization to work, it is important to construct an effective system of cooperation between pediatric institutes and respective hospitals. The dissemination of knowledge gathered at these pediatric institutions to other hospitals and physicians is also of great importance.