Abstract
All medical disciplines have undergone a qualitative development in the last decade, which has not missed even pediatric surgery. The introduction of new diagnostic methods, the use of new surgical procedures and devices and new knowledge in clinical medicine have led to important advances in the field of pediatric surgery.
In the last decade, pediatric surgery has been performed in addition to basic operations (appendectomy, abdominal wall hernia surgery, retention testis, routine trauma) mainly in specialized workplaces or by a certified pediatric surgeon. The incidence of certain diagnoses operating in childhood is low, so they have recently begun to concentrate in a specialized pediatric surgery department.
This trend is even more evident due to a significant decrease in birth rates in the Czech Republic. Real progress is being made on anesthesia and intensive postoperative care.
Parental nutrition is significantly improving. Patients tolerate long-term parental nutrition for 4-6 months without significant complications.
Diagnostic methods of recording great progress thanks to the introduction of ultrasonographic examination (ultrasound), computed tomography (CT) and magnetic resonance imaging (MRI). Flexible endoscopy of the gastrointestinal tract and respiratory tract has become a routine examination in childhood over the last 10 years.
Endoscopic retrograde cholangiopancreatography (ERCP) was introduced as a routine examination of children at the Motol University Hospital, in the last 2 years it can be performed in newborns. Another progress in the last decade has been the introduction of laparoscopy and thoracoscopy into routine practice in pediatric patients.
Funds in the last decade of birth in the Czech Republic have fallen to 90,000 live births per year, the number of operations per year at our workplace has decreased. In 1990 we operated on 2064 patients, in 1999 1934 patients.
Time has dropped significantly hospitalization of children after operations. For example, in 1989, the average length of hospitalization of children after appendectomy was 8 days, currently 5 days (after laparoscopic appendectomy 3-4 days).
The period of hospitalization after inguinal and umbilical hernia surgery and testicular retention surgery was 5 days in 1989, now patients are discharged to home treatment the day after surgery. In 1980, after lung resection, patients were hospitalized for the first 17 days, now 8 days.
A significant improvement for children and parents is the possibility of unlimited visits by parents for patients under 7 years of age.