背景:近几十年来,患有先天性异常和儿科癌症的儿童的生存率有了显著的改善,因此人们已经稳步地转向了解他们的终身健康结果.儿科医生将在儿童和青少年时期积极管理此类疾病,然而,成年外科医生必须在成年后照顾这些“成年人”。本文旨在强调需要长期随访的儿科外科医生遇到的一些罕见疾病,他们在童年的管理和他们的生存影响,以便成人专家可以更好地掌握管理这些患者成年的技能和知识。
方法:进行了全面的文献综述,以确定相关出版物。研究性研究,寻求审查文章和指导方针,重点关注儿童外科疾病的儿科管理和长期结局。这篇文章是为成人外科医生读者写的。
结果:本文描述了上述条件,他们在童年的管理和他们的终身影响,包括:食管闭锁,气管-食管瘘,旋转不良,短肠综合征,十二指肠闭锁,腹裂,exomphalos,胆总管畸形,胆道闭锁,先天性巨结肠病,肛门直肠畸形,先天性膈疝,先天性肺部病变和儿科癌症。
结论:受手术影响的儿童生存率的增加将转化为具有终身疾病和专科医疗保健需求的成年人群体的增长。从童年过渡到成年的重要性正在逐渐认识到。希望这次及时的审查将使读者热情地为这些脆弱的患者提供护理,并与儿科外科医生合作,提供成功和无缝的过渡护理。
BACKGROUND: In recent decades, the survival of children with congenital anomalies and paediatric cancer has improved dramatically such that there has been a steady shift towards understanding their lifelong health outcomes. Paediatric surgeons will actively manage such conditions in childhood and adolescence, however, adult surgeons must later care for these \'grown-ups\' in adulthood. This article aims to highlight some of those rare disorders encountered by paediatric surgeons requiring long-term follow-up, their management in childhood and their survivorship impact, in order that the adult specialist may be better equipped with skills and knowledge to manage these patients into adulthood.
METHODS: A comprehensive literature
review was performed to identify relevant publications. Research studies,
review articles and guidelines were sought, focusing on the paediatric management and long-term outcomes of surgical conditions of childhood. The article has been written for adult surgeon readership.
RESULTS: This article describes the aforementioned conditions, their management in childhood and their lifelong implications, including: oesophageal atresia, tracheo-oesophageal fistula, malrotation, short bowel syndrome, duodenal atresia, gastroschisis, exomphalos, choledochal malformations, biliary atresia, Hirschsprung disease, anorectal malformations, congenital diaphragmatic hernia, congenital lung lesions and paediatric cancer.
CONCLUSIONS: The increasing survivorship of children affected by surgical conditions will translate into a growing population of adults with lifelong conditions and specialist healthcare needs. The importance of transition from childhood to adulthood is becoming realized. It is hoped that this timely
review will enthuse the readership to offer care for such vulnerable patients, and to collaborate with paediatric surgeons in providing successful and seamless transitional care.