title: Neonatal gastrointestinal perforation in Japan: a nationwide survey.
abstract: OBJECTIVE
  The purpose of this study is to identify the current clinical features of neonatal gastrointestinal perforation in Japan.
  
  
  METHODS
  A questionnaire about cases of neonatal gastrointestinal perforation treated in recent 5 years was sent to participating institutions of the Japanese Society of Pediatric Surgeons (JSPS).
  
  
  RESULTS
  Five hundred and thirty-six neonates with gastrointestinal perforation were treated. They consisted of 42 patients with gastric rupture/perforation (GR), 33 patients with intestinal atresia/stenosis (IA), 3 patients with malrotation (ML), 118 patients with necrotizing enterocolitis (NEC), 160 patients with focal intestinal perforation (FIP), 46 patients with meconium-related ileus (MRI), 77 patients with meconium peritonitis (MP), and 57 patients with other conditions. The total mortality rate was 20.5 %. The mortality rates of the patients with GR, IA, ML, NEC, FIP, MRI, and MP were 9.5, 9.1, 0, 33.1, 20.6, 28.2, and 9.1 %, respectively. In 263 cases involving extremely low-birth-weight neonates (ELBW), 108 died (mortality rate 41.1 %). The mortality rates for ELBW with GR, NEC, FIP, MRI, MP, and other conditions were 27.3 % (3/11), 58.5 % (48/82), 21.6 % (24/111), 70.6 % (24/34), 57.1 % (4/7), and 27.8 % (5/18), respectively.
  
  
  CONCLUSIONS
  The mortality rates for ELBW decreased from 62.8 % in the previous survey to 41.1 % by the time of this survey.
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan. ms-sato@kitano-hp.or.jp.|Department of Pediatric Surgery, Kitano Hospital, The Tazuke Kofukai Medical Research Institute, 2-4-20, Ohgimachi, Kita-ku, Osaka, 530-8480, Japan. ms-sato@kitano-hp.or.jp.
authors.forename: Masahito
authors.identifier: http://orcid.org/0000-0002-2848-0275
authors.initials: M
authors.lastname: Sato
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hamada
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kohno
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Ise
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Ogata
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Masuyama
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Morotomi
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Yasufuku
authors.affiliation: Committee of Academic Surveys and Advanced Medical Science, Japanese Society of Pediatric Surgeons, Tokyo, Japan.
authors.forename: Motoshi
authors.initials: M
authors.lastname: Wada
mesh_terms: D020345:Enterocolitis, Necrotizing / Q000150:complications; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007416:Intestinal Perforation / Q000453:epidemiology* / Q000209:etiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D011159:Population Surveillance
keywords: Gastrointestinal perforation; IFALD; Japanese Society of Pediatric Surgeons; National clinical database; Nationwide surveillance; Neonatal surgery