Current status of neonatal surgery in Japan: An analysis of data from the National Clinical Database Pediatric Surgical Registry.

PURPOSE: To evaluate the current status of neonatal surgery in Japan based on the National Clinical Database-Pediatric (NCD-P) registry, a survey conducted every 5 years by the Committee of the Japanese Society of Pediatric Surgeons. METHODS: We summarized and compared the survey data on neonatal surgical cases from 2018 to 2023 using the NCD-P registry to analyze current trends. RESULTS: The total numbers of summarized cases in 2018 and 2023 were 2,828 and 2,544, respectively, reflecting a 10.0% reduction. A decline was observed in maternal transport cases among patients with a prenatal diagnosis, while there was no significant difference in the mortality rate among these patients. Regarding the number of cases of neonatal surgical diseases, anorectal malformations and esophageal atresia ranked first and second in both surveys. The number of gastroschisis cases declined markedly in 2023. Chronological change in the overall mortality was not significantly different between 2018 and 2023. In 2023, 185 neonates (10.1%) underwent endoscopic surgery. CONCLUSIONS: The survey data show that the overall mortality rate of neonatal surgical cases did not change from 2018 to 2023. The decrease in neonatal surgical cases seems to be mainly due to a decline in the national birth rate.