Department of Surgery, Westchester Medical Center, and New York Medical College, Valhalla, NY, USA; Operation Giving Back Bohol, Philippines; Department of Surgery, University of Arizona, Tucson, AZ, USA.
Operation Giving Back Bohol, Philippines; St. Joseph Hospital, Breese, IL, USA.
Int J Surg. 2018 Dec;60:15-21. doi: 10.1016/j.ijsu.2018.10.033. Epub 2018 Oct 22.
Surgical volunteer missions (SVMs) have become a popular approach for reducing the burden of surgical disease worldwide. The aim of this study was to evaluate the outcomes of 12 surgical missions between 2006 and 2018 from the mission entitled "Operation Giving Back Bohol" Tagbilaran, Philippines and discuss the lessons learned during these missions in particular seven challenges that every volunteer surgeon should be familiar with.
This was a retrospective descriptive study of prospectively collected data on all patients treated during one SVM. The data collected included gender, age, diagnosis, types of surgeries performed, and perioperative adverse events.
During the study period 1327 operations were performed (842 females (63.4%) and 485 males (36.6%); (male-to-female ratio 0.59); mean age 37 ± 18 years. The majority of operations were for thyroid disease (31.6%), followed by hernia (17.3%), hysterectomies/salpingo-oophorectomies (12.2%), soft tissue tumors (9.9%), cleft lip/palate repairs (7.2%), breast (6.4%), gallbladder disease (4.7%), cataract (2.9%), parotid masses (1.4%) and others (6.4%). For each mission, there were an average 5.5 days of operating, performing a median of 105.5 (80-148) cases per mission. There were 27 complications (2%), of which, 22 were postoperative bleeding and two temporary tracheostomies. The mortality rate was 0.15% (2/1327). In one patient, the family withdrew care following compassionate last ditch effort thyroidectomy for advanced cancer and one patient died as a result of intracranial bleeding from a brain tumor, which was unrecognized before mastectomy.
Surgical volunteerism missions are safe and valuable in lessening the burden of surgical disease globally when performed in an organized fashion and with continuity of care. However, there is need for standardization of surgical care provided during SVMs and creation of a world-wide database of all SVMs, and each surgeon and others who participate in these mission should be familiar with critical elements and challenges for the successful mission.
外科志愿任务 (SVM) 已成为减轻全球外科疾病负担的一种流行方法。本研究的目的是评估 2006 年至 2018 年间名为“Operation Giving Back Bohol”Tagbilaran, Philippines 的 12 次外科任务的结果，并讨论在这些任务中特别遇到的七个挑战，每个志愿外科医生都应该熟悉这些挑战。
这是一项回顾性描述性研究，对单次 SVM 中治疗的所有患者的数据进行了前瞻性收集。收集的数据包括性别、年龄、诊断、进行的手术类型以及围手术期不良事件。
在研究期间，共进行了 1327 次手术（842 名女性（63.4%）和 485 名男性（36.6%）；男女性别比为 0.59；平均年龄为 37±18 岁）。大多数手术是甲状腺疾病（31.6%），其次是疝（17.3%）、子宫切除术/输卵管卵巢切除术（12.2%）、软组织肿瘤（9.9%）、唇腭裂修复术（7.2%）、乳房手术（6.4%）、胆囊疾病（4.7%）、白内障（2.9%）、腮腺肿块（1.4%）和其他疾病（6.4%）。每次任务平均有 5.5 天的手术时间，每次任务中位数完成 105.5（80-148）例。有 27 例并发症（2%），其中 22 例为术后出血，2 例为临时气管切开术。死亡率为 0.15%（2/1327）。在一名患者中，由于晚期癌症进行了富有同情心的最后努力甲状腺切除术，家属停止了治疗，另一名患者因脑肿瘤导致颅内出血死亡，在乳房切除术前未被发现。
当以有组织的方式和持续的护理进行时，外科志愿任务在减轻全球外科疾病负担方面是安全且有价值的。然而，需要标准化 SVM 期间提供的外科护理，并创建一个全球性的所有 SVM 数据库，每个外科医生和其他参与这些任务的人员都应该熟悉成功任务的关键要素和挑战。
