Carmen Mesas Burgos

I am an Associate Professor in Pediatric Surgery at Karolinska Institutet and a consultant surgeon at Karolinska University Hospital in Stockholm, Sweden.

My clinical work centers on congenital anomalies, I have a particular focus on congenital diaphragmatic hernia, esophageal atresia, and abdominal wall defects, conditions I have spent much of my career trying to understand more deeply and treat more effectively. I am also an ECMO surgeon, and I'm proud to be part of one of Karolinska's most successful departments in this field, both nationally and internationally.

Beyond the operating room, I'm deeply engaged in the international scientific community. I currently serve as Editor-in-Chief of the European Journal of Pediatric Surgery Reports and as Co-Editor for Fetal Diagnosis and Treatment, roles that let me help shape how new research in our field reaches the surgeons and families who need it.

I am also an active member of ERNICA, the European Reference Network for rare pediatric surgical conditions, where I lead the Abdominal Wall Defects Workstream, and I sit on the boards of several international organizations close to my heart: the International Fetal Medicine and Surgery Society, the European Association of Pediatric Surgery's Network Office, and the UEMS Section of Pediatric Surgery.

One initiative I'm especially proud of is founding WoEUPSA: I started it because I felt there was a real need to support and connect women in our field, and it's been rewarding to watch it grow into a genuine community within European pediatric surgery.

Looking ahead, one of my main ambitions is to expand and develop fetal therapies; I believe there's enormous potential to intervene earlier and more precisely for conditions we currently only treat after birth, and building that capability is a central part of where I want to take my work in the coming years.

I have developed a broad researh interest, and my research addresses the full clinical trajectory of children born with severe congenital surgical malformations — from prenatal diagnosis and acute neonatal management through to adult reproductive health — using a combination of national population-based registries, prospective and randomized clinical trials, and patient-reported outcome measures.

The core of my work concerns congenital diaphragmatic hernia (CDH), gastroschisis, omphalocele, and esophageal atresia: conditions that were once uniformly fatal and are now survived by a majority of affected children, but whose long-term consequences remain poorly characterized. My research also focuses on extracorporeal membrane oxygenation (ECMO) as rescue therapy for the most severely affected infants, including national registry-based analyses (in collaboration with the Extracorporeal Life Support Organization, ELSO) of re-ECMO in CDH, the impact of prematurity on ECMO outcomes, and the specific challenges of hydrops fetalis and pediatric cannulation technique. Building on this, I lead a multicenter collaboration to develop standardized ECMO protocols and propensity-score methodology for CDH, alongside participation in the CoDiNOs and PiNC randomized controlled trials (with Erasmus MC, Rotterdam).

A second major strand of my research uses Sweden's linked national health registries: the Patient Register, the Medical Birth Register, the Multi-Generation Register, and Statistics Sweden's education register, to answer questions that are impossible to address in any single-center cohort, because the outcomes of interest are too rare or take decades to emerge. This has included population-based studies of outcomes after CDH and abdominal wall defects (gastroschisis and omphalocele). In parallel, I am extending this registry methodology to fertility and pregnancy outcomes in women born with CDH, gastroschisis, and omphalocele, a question with direct clinical relevance for preconceptional counselling and delivery planning that has, remarkably, never been studied at population level for these diagnoses.

Because congenital malformations are individually rare, no single country's data are sufficient to resolve many important clinical questions, which is why an important part of my work is building international consensus. Through ERNICA (the European Reference Network for rare inherited congenital malformations) and the European Paediatric Surgeons' Association (EPSA), I have coordinated several evidence-based guidelines and Delphi-based initiatives to define standardized quality indicators and outcome definitions, in areas where the literature has until now used dozens of incompatible definitions, making cross-study and cross-center comparison meaningless. This harmonization work extends into a Nordic collaboration, where I lead several research and educational projects, including implementation of Enhanced Recovery After Surgery (ERAS) protocols in pediatric surgery.

The final dimension of my research concerns how affected children and their families actually experience life after treatment, which registry data alone cannot capture. In collaboration with colleagues in Gothenburg, I study health-related and gastrointestinal-specific quality of life in gastroschisis and omphalocele survivors compared with healthy peers, and I supervise related work on quality of life after microtia reconstruction.

Across these projects, spanning acute critical care, epidemiology, clinical trials, international quality-improvement consensus work, and patient-reported outcomes, the unifying aim is the same: as survival for these conditions has become the norm rather than the exception, my research asks what a good long-term outcome actually means for these patients, and how we build the evidence base needed to achieve it, from the neonatal intensive care unit through to adulthood.

Teaching has been a consistent thread throughout my career, evolving alongside my clinical and research work. I began as an course assistans (Amanuens)  for the pediatric surgery course early in my carreer, which gave me an early appreciation for how much clarity and structure matter when introducing students to such a specialized field. Later, I took on the role of Chief of Residents (ST-studierektor, ) overseeing the training program for specialist trainees (ST-läkare) in pediatric surgery, a responsibility I found genuinely rewarding, shaping not just what trainees learned but how the specialty trains its next generation.

That interest in training standards has since taken me to the international level. I now serve as the UEMS representative for Sweden and sit on the European Board of Pediatric Surgery, working to help harmonize training and assessment standards for the specialty across Europe. Iam  also the only Scandinavian European examiner for pediatric surgery, a role I take seriously given how few of us hold it, and I'm one of three SPUR inspectors for our specialty in Sweden, evaluating training quality at specialist training sites nationally.

Alongside this, I hold a 60-credit (60 hp) Master's degree from Karolinska Institutet, which has given me a formal academic grounding to complement the teaching and assessment work I do.

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• Petra Nord, Congenital diaphragmatic hernia

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• prenatal risk factors, associated malformations, and the role of extracorporeal membrane oxygenation., 2025-

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• Sofia Eriksson, Epidemiological and long-term studies on Microtia, 2023-

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• Niklas Gustafsson, Aspects of Neonatal ECMO, 2021-

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• Katarina Tyden, Cardiac function in Congenital Diaphragmatic Hernia", 2025

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• Elin Öst, Health-Related Quality of Life, Psychosocial function and Physical function of patients born with CDH, 2018

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• Nader Ghaffarpour, Lymphatic malformations in Children, 2018

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• Cecilia Caldeman, Epidemiological studies on Gastroschisis

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• Anna Fogelström, Omphalocele from Early Diagnosis to Shared Definitions and Quality Indicators

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• Anders Grossman, Esophageal Atresia: Understandning risk factors and associated outcomes

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• Anna Rannebro, Weaning off ventilation in Neonates

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• Noa Ouwehand, Aspects of CDH care