J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text HTML] [Full Text PDF] （in Japanese / 806KB） [Members Only]

J.Jpn. Surg. Soc.. 127(1): 107-110, 2026

General contribution

CURRENT STATUS AND FUTURE CHALLENGES OF ADULT SURGICAL TREATMENT IN CHILDREN’S HOSPITALS

1) Department of Surgery, Nagano Children’s Hospital, Azumino, Japan
2) Department of Pediatric Surgery, Okayama University Hospital, Okayama, Japan
3) Department of Surgery, Aizawa Hospital, Matsumoto, Japan

Shigeru Takamizawa1), Katsumi Yoshizawa1), Tomoko Kasai1), Tomoaki Irie1), Hiroshi Okano1)2), Ayaka Adachi1), Kazuki Yoshizawa1), Kana Hisada1)3)

Adult patients with severe motor and intellectual disabilities (SMID), previously managed as pediatric cases, often remain under pediatric care into adulthood. In such instances, transition to adult internal medicine is frequently unachieved, and surgical referrals may go to pediatric rather than adult surgeons.
We retrospectively reviewed 36 adult SMID patients (43 procedures) referred from external institutions and treated surgically in our pediatric surgery department over the past decade. Median age at surgery was 25 years. Among these, 23 procedures were for hospitalized or institutionalized patients, and 40 involved SMID individuals.
Referrals originated from 14 institutions capable of adult surgery and 29 that were not. Referring departments included pediatrics (29 cases), internal medicine (12), and pediatric surgery (2). Procedures included gastrostomy (12), central venous catheter placement (9), laryngotracheal separation (5), fundoplication (3), brachiocephalic artery transection (3), tracheostomy (3), and others (8).
These findings highlight the need for structured transition systems from pediatric to adult care for SMID patients, and stronger collaboration between non-surgical and surgical-capable facilities through clinic-hospital and hospital-hospital networks.

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