Trisomy 21 and the pediatric surgeon.
OBJECTIVE
Trisomy 21 (Down syndrome) is a common condition encountered by the pediatric surgeon. The surgical anomalies associated with Down syndrome now have treatment options that were previously considered futile. An effective surgical team approach to these children involves knowledge of the unique pathophysiology of trisomy 21 and an appreciation for the desires of the family and the needs of the child.


RESULTS
Surgical techniques benefit children with Down syndrome equally as typical children. Pessimism regarding the outcome of surgical treatment of colorectal anomalies is fading, with evidence of nearly equivalent outcomes. Several autoimmune disorders impact children with Down syndrome. Idiosyncratic susceptibility to infections and malignancy is noted. Unique anesthetic complications and aerodigestive tract disorders have been identified. Many anomalies have surgical options that enhance the quality of life.


CONCLUSIONS
There is optimism in the surgical treatment of children with Down syndrome. Improved operations, better anesthetic management and recognition of problems specific to the child with trisomy 21 make it safer and ethical to offer surgical solutions. Societal acceptance and mainstream participation are on the rise. The astute, compassionate pediatric surgeon does much to enhance the quality of life of these children and of the families who love them.
Allshouse
Michael J
MJ
Pediatric Surgery, The Children's Hospital, Denver, Colorado 80218, USA. Allshouse.Michael@tchden.org
D002648:Child; D004314:Down Syndrome / Q000601:surgery*; D006801:Humans; D010372:Pediatrics / Q000379:methods*; D013514:Surgical Procedures, Operative / Q000379:methods*