Purpose: Pediatric surgery in Korea has historically been undervalued under the national fee system. Since 2021, the government has progressively expanded surgical add-on reimbursement for pediatric surgeries, yet their real-world impact remains unclear. Methods: We retrospectively analyzed pediatric surgeries (<19 years) performed at 4 tertiary institutions from 2020 to 2025. Surgeries were divided into 4 periods based on major policy changes. Variables included the number of surgeries, claimed surgical fees, patient age and weight, and eligibility for add-on reimbursement. Trends over time and variations among hospitals were examined. Results: A total of 1,959 surgeries were analyzed. Surgical volume did not significantly change across periods (P = 0.342).In contrast, total claimed surgical fees increased 1.66-fold in Period 2, 3.26-fold in Period 3, and 3.42-fold in Period 4 compared with Period 1. The proportion of surgeries eligible for add-on reimbursement rose to 76.6% in Period 4. The average claimed fee per case increased from 973,446 Korean won in Period 1 to 3,463,428 in Period 4. Patients <1,500g demonstrated the largest increase (471%). Across hospitals, the magnitude of claimed fee increases varied, but all institutions showed substantial growth in claimed surgical fees. Conclusion Stepwise expansion of pediatric surgical add-on reimbursement substantially increased claimed surgical fees across institutions without inflating surgical volume. These reforms improved financial reimbursement and may support future improvements in workforce sustainability, training, and care equity. Continuous policy monitoring will be essential to ensure long-term effectiveness and fiscal balance.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

Electroconvulsive therapy (ECT) has been recognized as an effective treatment for schizophrenia. However, its clinical utilization has been declining due to advancements in antipsychotic medications and the persistent stigma associated with the treatment. Clinical guidelines differ in their recommendations regarding the applications of ECT in schizophrenia treatment. Existing studies demonstrated that ECT is effective for treatment-resistant schizophrenia, clozapine-resistant schizophrenia, acute psychotic exacerbations, and patients at high risk of suicide, with enhanced efficacy when combined with antipsychotic medications. Despite its clinical benefits, concerns regarding cognitive impairment, social stigma, and limited accessibility have led to its underutilization. Addressing these challenges requires expanding educational efforts for clinicians, increasing public awareness, promoting further research into its long-term efficacy and cognitive effects, and implementing policy changes to improve accessibility. This review emphasizes the essential role of ECT in schizophrenia treatment and the need to reintegrate it as a viable and necessary treatment option for suitable patients.

Purpose: To report a nationwide survey on neuroblastoma conducted by the Korean Association of Pediatric Surgeons (KAPS) in 2020. Methods: The clinical data of pediatric patients diagnosed with and treated for neuroblastoma from 2005 to 2019 in 19 hospitals of KAPS members were collected. Survival and prognostic factor analyses were performed using the log rank test and Cox proportional hazard analysis. A p-value <0.05 was considered significant. Results: A total of 669 patients with neuroblastoma were registered for the study. The results were presented and discussed at the 36th annual meeting of the KAPS, which was held in Seoul on August 21, 2020. Conclusion This study provides information on patient demographics, prognostic outcomes, and comprehensive treatment outcomes for neuroblastoma. The study is expected to be an important reference for improving pediatric surgeons’ understanding and treatment of neuroblastoma.

Purpose: To report the findings of a perception survey on intestinal malrotation conducted by the Korean Association of Pediatric Surgeons (KAPS) in 2021. Methods: The perceptions on intestinal malrotation regarding clinical decision making of the KAPS members were collected through web-based survey. Results: A total of 22 surgeons were answered for this study. The results were presented and discussed at the 37th annual meeting of KAPS, which was held in Seoul on June 18, 2021. Conclusion This study provides the clinical decisions of the KAPS members on the intestinal malrotation. The study is expected to be an important reference for improving pediatric surgeons’ understanding and treatment of intestinal malrotation.

Purpose: Biliary atresia (BA) is a rare but progressive cholangiopathy and the leading cause of pediatric liver transplantation worldwide. The Korean Association of Pediatric Surgeons (KAPS) has conducted three national surveys (2001, 2011, and 2023) to assess long-term trends in the diagnosis, treatment, and outcomes of BA. This study provides a comparative analysis of the 2nd and 3rd national surveys, with reference to selected findings from the 1st survey. Methods: This study included 453 patients from the 3rd national survey (2011–2021) and 435 patients from the 2nd survey (2001–2010), all of whom underwent Kasai portoenterostomy. Data were collected via electronic case report forms from pediatric surgical centers nationwide. Comparisons were made regarding demographics, clinical features, diagnostic patterns, operative details, follow-up outcomes, and survival. Kaplan–Meier analysis was used to evaluate long-term survival. Results: The mean number of BA patients per year remained stable between surveys (43.5 in the 2nd, 41.18 in the 3rd), though centralization of care increased, with 61.5% of cases managed by two major institutions in the 3rd survey. The median age at surgery decreased, and the use of preoperative imaging (especially magnetic resonance cholangiopancreatography) increased. The 10-year native liver survival rate declined from 59.8% to 53.7%, while overall 10-year survival improved slightly (92.9% to 93.2%). Postoperative complications, such as cholangitis and liver failure, persisted but were better categorized. The 3rd survey also reported improved mortality (4.9%) and reduced follow-up loss (11.5%) compared to the 2nd survey. Conclusion While overall survival after Kasai operation has remained high and even improved, native liver survival has slightly declined. The findings reflect earlier diagnosis, more consistent diagnostic imaging, and increasing centralization of care. These trends underscore the importance of long-term nationwide data collection in guiding future strategies for BA management in Korea.

Purpose: This study aims to investigate and compare the incidence, demographic characteristics, clinical manifestations, preoperative diagnostic methods, anatomical classifications, associated anomalies, operative treatments, and postoperative outcomes of patients with intestinal atresia treated by the members of the Korean Association of Pediatric Surgeons (KAPS) through three nationwide surveys. Methods: KAPS conducted 3 national surveys in 1998, 2010, and 2024 to examine the patients diagnosed with intestinal atresia. In preparation for the survey, we developed a customized case registration form to obtain data on patient sex, birth weight, gestational age, clinical manifestations, preoperative diagnostic methods, anatomical types, associated anomalies, operative treatments, and postoperative outcomes. Authorized KAPS members completed the case registration form. Results: The first, second, and third national surveys included 218, 222, and 236 individuals diagnosed with intestinal atresia, respectively. The male-to-female ratios were 1.5:1, 1.1:1, and 1.1:1, respectively. The first, second, and third national surveys revealed that 34.3%, 43.3%, and 53.4% of patients were born before 37 weeks of gestation, respectively. Additionally, 28.7%, 32.0%, and 40.7% of patients had a birth weight under 2,500 g. In the third national survey, duodenoduodenostomy was the most common procedure, performed in 70 out of 82 patients diagnosed with duodenal atresia. Resection and anastomosis were the main surgical procedures conducted in 47 out of 54 cases of jejunal atresia and 74 out of 92 cases of ileal atresia. The mortality rates in the first, second, and third national surveys were 13.8%, 3.6%, and 1.3% respectively, with the lowest rate observed in the third national survey. Conclusion These national surveys offer valuable insights into the current state of intestinal atresia, including specific surgical interventions and postoperative outcomes in South Korea. For pediatric surgeons aiming to enhance their understanding of intestinal atresia and its treatment options, these surveys could be an indispensable resource and guide.