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June 2014

The Maturation of Children With Congenital Anomalies: Who Will Be Their Providers?

Author Affiliations
  • 1Department of Surgery, UC Davis Health Systems, Sacramento, California
JAMA Surg. 2014;149(6):501-502. doi:10.1001/jamasurg.2013.4873

The 20th century marked a turning point in the development of pediatric surgery. At one time considered the younger stepchild of adult surgery, the field has matured into a distinct entity that encompasses surgical diseases and interventions unique to the pediatric patient. Congenital anomalies once considered fatal, such as esophageal atresia, Hirschsprung disease, and gastroschisis, are now survived by more than 90% of patients. Yet as Giuliani and Anselmo1 point out in their Viewpoint in this issue of JAMA Surgery, the ongoing maturation and specialization of pediatric surgery has produced a novel challenge: as pediatric mortality rates decrease, adult surgical systems must increasingly provide multimodal care for the sequelae of previously nonsurvivable conditions. As first happened with cystic fibrosis, the increased survival rate of children with these diseases has left adult survivors without qualified adult physicians to care for their “unique” condition.