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Background: Pediatric day case surgeries performed in the rural setting of medical outreach is of great benefit to the patients who could not have access to specialist pediatric surgical care. The purpose of study was to evaluate our experience in carrying out pediatric day case surgeries during medical outreaches in the rural settings of Enugu, south east Nigeria.Methods: This was a retrospective study of children that had day case surgeries during medical outreach in the rural areas of Enugu, south east Nigeria, over a 5-year period. The patients' demographics, duration of symptoms, diagnosis, operative procedure performed, outcome of treatment and complications of treatment were evaluated.Results: During the study period, a total of 108 cases of pediatric day case surgeries were performed which accounted for 58.7% of all medical outreach surgeries. There were 81 (75%) males and 27 (25%) females, with a male to female ratio of 3:1. The median age of the patients was 54 months with a range of 10 -72 months. The median duration of the lesions was 7 months. Herniotomy for inguinal hernia and hydrocele was the most common performed surgical procedure. All the surgeries were performed under general anesthesia. Outcome was good in most of the patients. Surgical site infection was the most common post-operative complication. There was no mortality. Conclusion:Pediatric surgical outreach programs offer opportunity for the treatment of surgical lesions of children in the rural areas who do not have access to specialist pediatric surgical care. Pediatric surgical outreach program can achieve reduction in surgical disease burden of children in the rural areas.
Background: Pediatric day case surgeries performed in the rural setting of medical outreach is of great benefit to the patients who could not have access to specialist pediatric surgical care. The purpose of study was to evaluate our experience in carrying out pediatric day case surgeries during medical outreaches in the rural settings of Enugu, south east Nigeria.Methods: This was a retrospective study of children that had day case surgeries during medical outreach in the rural areas of Enugu, south east Nigeria, over a 5-year period. The patients' demographics, duration of symptoms, diagnosis, operative procedure performed, outcome of treatment and complications of treatment were evaluated.Results: During the study period, a total of 108 cases of pediatric day case surgeries were performed which accounted for 58.7% of all medical outreach surgeries. There were 81 (75%) males and 27 (25%) females, with a male to female ratio of 3:1. The median age of the patients was 54 months with a range of 10 -72 months. The median duration of the lesions was 7 months. Herniotomy for inguinal hernia and hydrocele was the most common performed surgical procedure. All the surgeries were performed under general anesthesia. Outcome was good in most of the patients. Surgical site infection was the most common post-operative complication. There was no mortality. Conclusion:Pediatric surgical outreach programs offer opportunity for the treatment of surgical lesions of children in the rural areas who do not have access to specialist pediatric surgical care. Pediatric surgical outreach program can achieve reduction in surgical disease burden of children in the rural areas.
Surgical outreach Program is a platform where a large number of elective surgical patients are treated within a short time, usually on ambulatory basis by a volunteer surgical team at no cost to the patients. Inguinal hernia repair is usually the commonest procedure performed. However, acute postoperative pain associated with it is not often investigated in our environment.All adult patients with uncomplicated inguinal hernia who consented to the study were recruited. The choice of anaesthesia, surgical technique and postoperative analgesics used were as per the discretion of the individual surgical team members. Postoperatively, the patients were interviewed through a telephone call using a structured questionnaire for three consecutive days after the surgery. Data obtained were analyzed using SPSS version 16.A total of 43 patients, 34 males, 9 females were recruited. The mean age was 42.86 years. Local anaesthesia (LA) only was the commonest anaesthetic technique (42.2%), followed by LA + sedation (30.2%). Unimodal analgesic regimen as against multimodal regimen was used in 46.5% and 53.5% patients respectively. The incidence of moderate to severe pain was highest on the first day after surgery (72.5%), and it was statistically significant compared with No pain/mild pain (27.5%), p value = 0.002. More patients treated with unimodal compared with multimodal analgesic regimen had moderate to severe pain (56.7% vs 43.3%).Surgical outreach program is useful in reducing surgical disease burden. However, the incidence of acute moderate to severe postoperative pain is high (72.5%). Therefore, a standard protocol that is effectively communicated to all members of the surgical team must be developed in order to reduce this morbidity.
Background: Conditions that are amenable to surgery are found globally. However, surgery is not easily accessible for most people in low- and middle-income countries due to physical and financial barriers, among others. One-way of mitigating against this situation is through surgical outreach programmes. Patients and Methods: A paediatric surgical outreach in a teaching hospital in the Central Region of Ghana was carried out by a paediatric surgeon from Korle Bu Teaching Hospital. Data on the cases done from June 2011 to June 2014 were analysed. Results: A total of 185 patients had surgery during the study. There were 153 males with the mean age of 4.53 ± 3.67 years. Patients aged 1–5 years represented 51.9% of the patients. Twenty-four (13%) had major surgery and 161 (87%) had minor operations. The most common minor operation performed was inguinal herniotomy representing 47.2% of the cases. None of the patients had any complications. Conclusion: The need for paediatric surgical outreach programme has been shown in this paper as well as its cost-effectiveness. With the current rate of graduation of paediatric surgeons in Ghana, paediatric outreach programmes will be needed in Ghana in the foreseeable future. This outreach should be extended to other regions of the country to cover a larger percentage of children in Ghana.
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