{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T02:56:31Z","timestamp":1787972191856,"version":"build-2784847793"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"05","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr Surg"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>\n          Introduction\u2003Adequate patient volume is essential for the maintenance of quality, meaningful research, and training of the next generation of pediatric surgeons. The role of university hospitals is to fulfill these tasks at the highest possible level. Due to decentralization of pediatric surgical care during the last decades, there is a trend toward reduction of operative caseloads. The aim of this study was to assess the operative volume of the most relevant congenital malformations at German academic pediatric surgical institutions over the past years.<\/jats:p><jats:p>\n          Methods\u2003Nineteen chairpersons representing university-chairs in pediatric surgery in Germany submitted data on 10 index procedures regarding congenital malformations or neonatal abdominal emergencies over a 3-year period (2015 through 2017). All institutions were categorized according to the total number of respective cases into \u201chigh,\u201d \u201cmedium,\u201d and \u201clow\u201d volume centers by terciles. Some operative numbers were verified using data from health insurance companies, when available. Finally, the ratio of cumulative case load versus prevalence of the particular malformation was calculated for the study period.<\/jats:p><jats:p>\n          Results\u2003From 2015 through 2017, a total 2,162 newborns underwent surgery for congenital malformations and neonatal abdominal emergencies at German academic medical centers, representing 51% of all expected newborn cases nationwide. The median of cases per center within the study period was 101 (range 18\u2013258). Four institutions (21%) were classified as \u201chigh volume\u201d centers, four (21%) as \u201cmedium volume\u201d centers, and 11 (58%) as \u201clow volume\u201d centers. The proportion of patients operated on in high-volume centers varied per disease category: esophageal atresia\/tracheoesophageal fistula: 40%, duodenal atresia: 40%, small and large bowel atresia: 39%, anorectal malformations: 40%, congenital diaphragmatic hernia: 56%, gastroschisis: 39%, omphalocele: 41%, Hirschsprung disease: 45%, posterior urethral valves: 39%, and necrotizing enterocolitis (NEC)\/focal intestinal perforation (FIP)\/gastric perforation (GP): 45%.<\/jats:p><jats:p>\n          Conclusion\u2003This study provides a national benchmark for neonatal surgery performed in German university hospitals. The rarity of these cases highlights the difficulties for individual pediatric surgeons to gain adequate clinical and surgical experience and research capabilities. Therefore, a discussion on the centralization of care for these rare entities is necessary.<\/jats:p>","DOI":"10.1055\/s-0041-1740479","type":"journal-article","created":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T23:44:51Z","timestamp":1642117491000},"page":"391-398","source":"Crossref","is-referenced-by-count":22,"title":["Operative Volume of Newborn Surgery in German University Hospitals: High Volume Versus Low Volume Centers"],"prefix":"10.1055","volume":"32","author":[{"given":"Martin","family":"Lacher","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Barthlen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery Greifswald, University of Greifswald, Mecklenburg-Vorpommern, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicitas","family":"Eckoldt","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Universit\u00e4tsklinikum Jena, Jena, Th\u00fcringen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Fitze","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of Dresden, Dresden, Saxony, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Fuchs","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery and Pediatric Urology, University Tuebingen, Tuebingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Hosie","sequence":"additional","affiliation":[{"name":"Muenchen Klinik gGmbH, Muenchen, Klinik Schwabing, Technische Universitaet Muenchen, Bavaria, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M.","family":"Kaiser","sequence":"additional","affiliation":[{"name":"Department of Paediatric Surgery, Martin Luther University Halle Wittenberg, Halle, Sachsen-Anhalt, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Meyer","sequence":"additional","affiliation":[{"name":"Pediatric Surgery Unit, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2790-4395","authenticated-orcid":false,"given":"Oliver J.","family":"Muensterer","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medicine Mainz, Johannes Gutenberg University Mainz, Rhineland-Palatinate, Germany"},{"name":"Department of Pediatric Surgery, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, M\u00fcnchen, Bavaria, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Reinshagen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf Hamburg, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Rothe","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Pediatric Surgery, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido","family":"Seitz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University Hospital Giessen\/Marburg, Marburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard","family":"Stuhldreier","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, University of Rostock, Rostock, 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