A 7‐Year Review of the Safety of Tonsillectomy during Short‐Term Medical Mission Trips

ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

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“…Simpler procedures, such as tonsillectomy, appear safe when performed by short-term surgical missions [52]. Others less so: Maine et al [53].…”

Section: Resultsmentioning

confidence: 99%

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

2014

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“…8,9 The otolaryngology literature is similarly limited. 10 Sykes et al 11 reviewed the results of seven annual short-term missions to Guatemala. Among 197 patients undergoing tonsillectomy, they found a low rate of immediate post-tonsillectomy hemorrhage and a single readmission for dehydration.…”

Section: Results Of Short-term Surgical Missionsmentioning

confidence: 99%

Results of pediatric tympanoplasty on short‐term surgical missions

Isaacson

Melaku

2015

The Laryngoscope

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“…Short-term medical missions (STMMs) appear to be the most common terminology used throughout the related literature to refer to the activity whereby physicians who are gainfully engaged in medical and surgical practices in their home countries leave those practices for a few days to a few weeks to provide uncompensated services directly to the ostensibly poor in lower and middle income countries (LMICs)*. [1][2][3] Such excursions are planned and are distinguished from ad hoc responses to domestic or external disasters, compensated relief practice such as Médecins Sans Frontières, military, and other governmental relief expeditions and medical school or residency training programs. These deployments are not regulated nor are they systematically linked through any common association or agency, so dimensions of the activity internationally or nationally have remained ill-defined.…”

Section: Introductionmentioning

confidence: 99%

Why do they care? Narratives of physician volunteers on motivations for participation in short‐term medical missions abroad

Caldron¹,

Impens

Pavlova

et al. 2017

Health Planning & Management

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Personality traits may be more influential to participation than demographic, professional, or socioeconomic determinants. Word-of-mouth recruitment appears to underlie the increase in STMM activity, facilitated by information technology. Reported key motivators for physician participation in STMMs tend to parallel schools of thought regarding philanthropy and volunteering and include satisfaction from helping in challenging conditions of limited resources, learning experiences, appreciation from patients, sense of renewal, and the legacy effect of teaching.

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A 7‐Year Review of the Safety of Tonsillectomy during Short‐Term Medical Mission Trips

Cited by 23 publications

References 9 publications

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Charitable Platforms in Global Surgery: A Systematic Review of their Effectiveness, Cost‐Effectiveness, Sustainability, and Role Training

Results of pediatric tympanoplasty on short‐term surgical missions

Why do they care? Narratives of physician volunteers on motivations for participation in short‐term medical missions abroad

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