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几内亚比绍的农村外科手术:土耳其世界医生组织的一项经历

Rural surgery in Guinea Bissau: an experience of Doctors Worldwide Turkey.

作者信息

Alimoglu Orhan, Sagiroglu Julide, Eren Tunc, Kinik Kerem

机构信息

Department of General Surgery, Istanbul Medeniyet University School of Medicine, Istanbul, Turkey.

Department of Disaster Medicine, Bezm-i Alem University School of Medicine, Vakif Gureba Hospital, Istanbul, Turkey.

出版信息

North Clin Istanb. 2015 Dec 25;2(3):196-202. doi: 10.14744/nci.2015.10327. eCollection 2015.

Abstract

OBJECTIVE

In Africa, there is critical shortage of surgeons. Majority of the surgeons work in urban centers, and almost none of them is working in the rural areas. This study documents surgical interventions performed in Guinea-Bissau by Doctors Worldwide Turkey.

METHODS

A group of surgeons from the Doctors Worldwide Turkey performed various surgical interventions in the Simao Mendes, Gabu and Bafata community hospitals. Demographics, surgical methods, anesthesia techniques and complications were recorded.

RESULTS

Sixty- four procedures were undertaken between 5-16 February 2010 and 6-11 May 2011. The patient population consisted of 47 male (82.5%) and 10 female (17.5%) patients with a mean age of 44.5 (range: 6-81) years. Five emergency cases were observed. Hartmann's procedure for rectal carcinoma; modified radical mastectomy for breast carcinoma; 2 right total thyroidectomies, 1 bilateral subtotal thyroidectomy; 2 incisional hernia repairs with mesh, 1 breast lumpectomy, 3 mass excisions, 2 keloidectomies, and various techniques of hernia repair for 35 inguinal hernias (4 bilateral, 3 strangulated and 2 coexisting with hydrocele), Winkelmann's procedure for 5 hydroceles (1 bilateral), and unilateral orchiectomy for 1 bilateral hydrocele were recorded. Sixteen patients received general (23.5%), 23 spinal (33.8%), 7 epidural (10.3%), 15 local (22.1%), and 7 ketamine (10.3%) anesthesia. There was no mortality.

CONCLUSION

Surgical diseases, majority of which are hernias threaten public health in underdeveloped regions of Africa. Blitz surgery may be an efficient temporary solution.

摘要

目的

在非洲,外科医生严重短缺。大多数外科医生在城市中心工作,几乎没有人在农村地区工作。本研究记录了土耳其世界医生组织在几内亚比绍实施的外科手术干预情况。

方法

一组来自土耳其世界医生组织的外科医生在锡芒·门德斯、加布和巴法塔社区医院实施了各种外科手术干预。记录了人口统计学信息、手术方法、麻醉技术和并发症情况。

结果

在2010年2月5日至16日和2011年5月6日至11日期间共进行了64例手术。患者群体包括47名男性(82.5%)和10名女性(17.5%),平均年龄为44.5岁(范围:6至81岁)。观察到5例急诊病例。记录了直肠癌的哈特曼手术;乳腺癌的改良根治性乳房切除术;2例右侧全甲状腺切除术、1例双侧次全甲状腺切除术;2例使用网片修补切口疝、1例乳房肿块切除术、3例肿物切除术、2例瘢痕疙瘩切除术,以及针对35例腹股沟疝(4例双侧、3例绞窄性和2例合并鞘膜积液)的各种疝修补技术,5例鞘膜积液的温克尔曼手术(1例双侧),以及1例双侧鞘膜积液的单侧睾丸切除术。16例患者接受全身麻醉(23.5%)、23例接受脊髓麻醉(33.8%)、7例接受硬膜外麻醉(10.3%)、15例接受局部麻醉(22.1%)和7例接受氯胺酮麻醉(10.3%)。无死亡病例。

结论

外科疾病,其中大多数是疝,威胁着非洲欠发达地区的公众健康。闪电式手术可能是一种有效的临时解决方案。

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