Pediatric surgery in India - a specialty come of age?

The quality of neonatal surgical care and scientific publications are reliable yardsticks that were used to assess the status of pediatric surgery in India. A specific questionnaire to assess neonatal care and surgical outcome was mailed to all institutes imparting pediatric surgery training. Data were obtained regarding the outcome of important neonatal surgical conditions for the year 1998 and a PubMed literature search was performed to identify scientific articles between 1995 and 2000. Though a literature search was done to compile a complete list of publications of all the consultants in all the institutes, of the 24 questionnaires mailed, only 11 (45.8%) institutes provided data. The mean (range) annual neonatal admissions in neonatal surgical units was 137 (42-263). The mean newborn admissions requiring surgical intervention per surgeon per year was 36 (17-80). The overall survival was 57.2% (30%-75%), 70.8% (40%-100%), 90.4% (75%-100%), 74.7% (30%-100%), and 59.1% (0%-100%) for esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), congenital diaphragmatic hernia, anorectal malformations, intestinal atresia, and abdominal-wall defects, respectively. The center that had the lowest survival in EA/TEF and CDH had the highest workload per consultant. Between 1995 and 2000, the mean number of scientific articles published in indexed journals compiled from all the institutes (n = 24) was 10.7 (0-84). In conclusion, this is a preliminary study toward setting up national databases of neonatal surgery in different parts of the world to set goals for improvement.