Research: Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery

Ital J Pediatr

. 2020 Sep 16;46(1):134. doi: 10.1186/s13052-020-00889-2.

Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery

Gloria Pelizzo 1Pietro Bagolan 2Francesco Morini 2Mariagrazia Aceti 3Daniele Alberti 4Mario Andermarcher 5Luigi Avolio 6Fabio Bartoli 7Vito Briganti 8Sebastiano Cacciaguerra 9Francesco S Camoglio 10Pierluca Ceccarelli 11Maurizio Cheli 12Fabio Chiarenza 13Enrico Ciardini 5Marcello Cimador 14Ennio Clemente 15Denis A Cozzi 16Luigi Dall’ Oglio 17Ugo De Luca 18Carmine Del Rossi 19Ciro Esposito 20Diego Falchetti 21Silvana Federici 22Piergiorgio Gamba 23Valerio Gentilino 24Girolamo Mattioli 25Ascanio Martino 26Mario Messina 27Bruno Noccioli 28Alessandro Inserra 29Pierluigi Lelli Chiesa 30Ernesto Leva 31Francesco Licciardi 32Paola Midrio 33Maria Nobili 7Alfonso Papparella 34Guglielmo Paradies 35Giuseppe Piazza 36Alessio Pini Prato 37Fabio Rossi 38Giovanna Riccipetitoni 6Carmelo Romeo 39Domenico Salerno 40Alessandro Settimi 41Jurgen Schleef 42Mario Milazzo 43Valeria Calcaterra 44Mario Lima 45Affiliations expand

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Introduction: This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy.

Methods: A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units.

Results: The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern <Northern<Central, p < 0.03). The most frequent clinical characteristics of neonates was preterm neonates with birthweight < 1200 g, with cardiorespiratory instability and/or ventilatory dependence. The most frequently selected indications to surgery were pneumothorax, pleural effusion, pericardial effusion, central venous catheter (CVC) positioning, intestinal perforation, patent ductus arteriosus ligation and congenital diaphragmatic hernia. More than 60% of respondents report no institutional recommendations and dedicated informed consent on bedside surgical procedures. The lack of dedicated areas and infrastructures is considered a relative contraindication to the performance of bedside surgery.

Conclusion: Bedside surgery is performed in the majority of the Italian pediatric surgery centers included in this census. The introduction of a national set of surgery guidelines would be widely welcomed.

Keywords: Bedside surgery; Critically ill neonates; Intrahospital transport; Neonatal intensive care unit; Operative room.

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