Twenty-year trends in neonatal surgery based on a nationwide Japanese surveillance program

Aim: To discuss the chronological changes observed in a national survey of neonatal surgery in Japan performed every 5 years by the Committee in the Japanese Society of Pediatric Surgeons. Methods: We analyzed the data obtained for 20 years from 1993 to 2013 and herein report the chronological changes. Results: The number of summarized cases was least in 1993, with 2806 cases, and subsequently increased to 3753 cases in 2013. The mortality rate among the patients with maternal transport linearly decreased (p = 0.0386). Although the proportion of extremely low birth weight infants linearly increased (p = 0.0014), with an annual rate of +0.39 %, the mortality rate linearly decreased (p = 0.0010), with an annual rate of −1.68 %. Moreover, the overall mortality rate linearly decreased (p = 0.0002), with an annual rate of −0.26 %. Most diseases were observed to exhibit a decline in the mortality rate with the same trend as overall mortality. The decline in the mortality rate was most robust with respect to congenital diaphragmatic hernia (CDH). The mortality rates, except for that of CDH, omphalocele, esophageal atresia, and intestinal perforation, declined to 5 % or lower by 2013. Conclusions: The present findings may be the result of remarkable progress in perinatal management.