[ Outcomes following the establishment of Qatar's quaternary neonatal general surgical service in a hospital with a “Tabula Rasa” for service development | Journal of Neonatal Surgery 2021

Basem A Khalil Consultant Paediatric Surgeon, Alder Hey Children’s Hospital, Liverpool, UK and Former Director of Neonatal Surgery, Sidra Medicine, Doha, Qatar.

Abdalla E Zarroug Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar.

Abubakr Elawad Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar.

Saad Moussa Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar.

Collette Donnelly Advanced Paediatric Nurse Practitioner (General Surgery) Royal Belfast Hospital for Sick Children and Former Advanced Nurse Practitioner, Division of Paediatric Surgery, Sidra Medicine, Qatar

Saleem Mammoo Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Guy Brisseau Division of Paediatric General and Thoracic Surgery, Sidra Medicine, Doha, Qatar

Alison Bedford Russell Senior Attending Neonatologist and Former Deputy Chief, Division of Neonatology and Neonatal Intensive Care, Sidra Medicine, Doha, Qatar

Helmut Hummler Former Chief, Division of Neonatology and Neonatal Intensive Care, Sidra Medicine, Doha, Qatar

Background: Sidra Medicine is the first dedicated Children and Maternity hospital in the State of Qatar. This paper describes the preparations for and results of activating quaternary neonatal surgical services in a brand new, "greenfield" hospital. We believe that these are the first published national results of neonatal general surgical services from the Gulf region. Methods: A review of surgical babies below four weeks corrected age from 1st of April 2018 - 31st of March 2020 was undertaken. Patient demographics, primary diagnosis, surgical procedures, 30-day postoperative mortality, overall mortality, and cause of death were recorded. Results: One hundred and sixty-nine babies (169) were identified (44.4% term and 55.6% preterm). Major surgery included laparotomy (76), congenital diaphragmatic hernia repair (20), surgery for anorectal malformations (25), and esophageal atresia (13). One set of conjoined twins were also separated successfully. Fourteen babies died, resulting in overall mortality of 8.3 %. Excluding babies who died of life-limiting conditions, two babies died within 30 days of surgery, resulting in 30 days postoperative mortality rate of 1.2 %. Conclusions: The neonatal surgical mortality rate is comparable with those from top international centers. This low rate could be attributed to the high level of expertise preceded by months of preparations