Research Letter
April 2016

Defining the Need for Transitional Care From Pediatric to Adult Surgery for Young Adult Patients With Surgically Corrected Congenital Anomalies

Author Affiliations
  • 1University at Buffalo, State University of New York, Buffalo, New York
  • 2Hospital for Sick Children and Department of Surgery, University of Toronto, Toronto, Ontario, Canada
  • 3Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
  • 4Floating Hospital for Children at Tufts Medical Center, Boston, Massachusetts
  • 5Women and Children’s Hospital of Buffalo, Buffalo, New York

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA Surg. 2016;151(4):393-394. doi:10.1001/jamasurg.2015.4417

A child born with a congenital birth defect today has a much higher probability of reaching adulthood than in the past. Significant advances in neonatal resuscitation and surgical management have improved prognoses for diseases such as congenital diaphragmatic hernia, esophageal atresia, and imperforate anus. As these children grow into adolescence, new challenges emerge as results from long-term studies that show ongoing morbidity among adolescent and adult survivors demonstrate a clear need for structured and formal transitional care.1,2 Unanswered, however, are the questions of how and when the transition of care should take place. Few quantitative data exist about patients’ transition to adult care and their long-term follow-up. A growing body of literature suggests that there are long-term sequelae of many surgically corrected congenital anomalies, such as metaplastic changes in patients with esophageal atresia repair and chest wall deformities in patients undergoing thoracotomy in infancy. Survivors of congenital surgical disease are those who will benefit most from standardized approaches to transitional care. Our study seeks to quantify the need for transitional surgical care for pediatric patients with surgical anomalies in the coming decades.

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