CRITICAL AND INNOVATIVE SURGICAL PROCEDURES IN NEONATAL MEDICINE: A SYSTEMATIC REVIEW

Neonatal surgery encompasses some of the most technically demanding procedures in all of medicine, performed on patients whose physiological reserves are extraordinarily limited. This article reviews the pathophysiology, operative strategies, perioperative considerations, and long-term outcomes associated with the most critical surgical conditions encountered in the neonatal period, including congenital diaphragmatic hernia, esophageal atresia with tracheoesophageal fistula, abdominal wall defects, necrotizing enterocolitis, Hirschsprung disease, intestinal atresias, and anorectal malformations. The physiological vulnerabilities unique to neonates - including transitional cardiovascular circulation, thermoregulatory instability, immature coagulation, and pharmacokinetic differences - are discussed as they pertain to anesthetic and surgical decision-making. Ethical dimensions, including fetal intervention and end-of-life considerations, are also addressed.