Facts and Figures

Facts and Figures About Congenital Abnormalities Treated by Paediatric Surgeons
by Dr. Ranjan Dias MS, FRCS – Senior Lecturer, Department of Surgery, Faculty of Medicine, Colombo.
Compiled from a talk given in November, 1997

Birth Prevalence of Some Congenital Malformations Treated by Paediatric Surgeons
(Per 1000 live births)

Hypospadias 3
Facial cleft 1.5
Neural Tube Defect 1
Imperforate Anus 0.4
Exomphalos 0.3
Diaphragmatic Hernia 0.25
Intestinal Atresia 0.25
Oesophageal Atresia +/-TOF 0.2
Hirschsprungs Disease 0.06
Ectopic Vesicae 0.05
Posterior Urethral Valves 0.02

Some Congenital Malformations Admitted to the Lady Ridgeway Hospital for Children
(Sri Lanka’s Premier Childrens Hospital) In 1995

(Total No. of registered births – 349,596)

Cleft Palate 230
Hypospadias 185
Club Foot 163
Cleft Lip 149
Imperforate Anus 118
PUJ Obstruction 88
Posterior Urethral Valve 76
Undescended Testes 66
Meningocele 33
Biliary Atresia 17
Diapharagmatic Hernia 12
Duodenal Atresia 10
Oesophageal Atresia 12
Ectopia Vesicae 7

Aims of Surgery in Congenital Malformations

Child – Functional, Physical/Sexual, Mental and Cosmetic Improvement
Parents – Reduce Parental Anxiety/Trauma
Save ‘Life’
Improve Quality Of Life
Produce An Individual Who Feels Adequate And Is A Useful Member Of The Society

Neonatal Surgery Requires

Intensive Care Unit / SCBU
Special Anesthetic Facilities
Special Operation Theatre Conditions
Competent Surgical Team With Experience
Availability of Facilities for Subspecialities
Paediatric
Neonatologist
Cardiac surgery
Neuro-Surgery

Cost

Quantifiable

Emoluments of Staff
Investigations
Medicine/Consumables
Food
Maintenance
Administration

Not quantifiable

Delay Or Deprivation Of Surgery For Other Children
Loss Of Working Hours Of Parents
Effects On The Other Siblings Of The Family
Demand On The Welfare Facilities Of The Country

Outcome After Optional Surgical Treatment

1. Normal or Near-Normal, Independent Person
2. Mild Residual Deformity But Independent Person
3. Significant Residual Deformity – With Varying Degrees Of Dependency
4. Any Of The Above With Subnormal Mental Functions
5. Any Of The First 3 With Severe Mental Retardation

Surgical Cost At the Lady Ridgeway Hospital for Children in 1995

‘SUPER – MAJOR’ SURGERY
eg. Repair of Oesp. atresia ‘Pull-through’ for Hirschsprung’s Rs.5240.00

MAJOR SURGERY
eg.Cleft plate repair Rs.2620.00

INTERMEDIATE SURGERY
eg. Orchidopexy Rs.1310.00

MINOR SURGERY Rs. 654.00

Cost per patient day in ICU Rs.4692.00
Cost per patient day in Surgical ward Rs. 564.00
Cost per patient day in medical ward Rs. 394.00

Repair of Oesophageal atresia with TOF Surgery Rs.5240.00
7 days in ICU Rs.32844.00
7 days in surgical ward Rs. 3948.00
TOTAL Rs.42032.00

SOURCE: Deputy Director. Lady Ridgeway Hospital for Children Colombo.