Masuya Ryuta, Muto Mitsuru, Nakame Kazuhiko, Murakami Masakazu, Sugita Koshiro, Yano Keisuke, Onishi Shun, Harumatsu Toshio, Yamada Koji, Yamada Waka, Matsukubo Makoto, Kaji Tatsuru, Nanashima Atsushi, Ieiri Satoshi
Division of the Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki-gun, Japan.
Department of Pediatric Surgery, Research Field in Medicine and Health Sciences, Medical and Dental Sciences Area, Research and Education Assembly, Kagoshima University, Kagoshima, Japan.
J Laparoendosc Adv Surg Tech A. 2022 May;32(5):571-575. doi: 10.1089/lap.2021.0713. Epub 2022 Feb 25.
The distribution of board-certified pediatric surgeons (BCPSs) in Japan is highly biased. While Prefecture has one of the smallest numbers of BCPSs per pediatric population, neighboring Prefecture has one of the largest numbers of BCPSs per pediatric population. We examined the effect of BCPSs population on laparoscopic surgery and postoperative management and outcomes. We compared postoperative duration to full-dose enteral nutrition, postoperative hospital stay, and complications of neurologically impaired patients who underwent laparoscopic fundoplication in two prefectures from 2006 to 2019. Laparoscopic fundoplication was performed in 17 patients in Prefecture and 63 in . The mean operative time was 248.8 ± 79.9 minutes in Prefecture and 260.8 ± 94.8 in ( = .64). The median number of days to full-dose enteral nutrition was 11.5 in Prefecture and 10 in ( = .29). The median postoperative hospital stay was 14 days in Prefecture and 15 days in ( = .38). Postoperative complications occurred in 7 cases in Prefecture and in 10 in . The incidence was significantly higher in Prefecture than in ( = .041). Areas with insufficient numbers of BCPSs have a higher risk of complications in laparoscopic surgery than areas with sufficient numbers.
