Gachabayov Mahir, Latifi Rifat
Department of Surgery, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
Operation Giving Back Bohol, Philippines.
Gland Surg. 2019 Aug;8(4):385-388. doi: 10.21037/gs.2019.06.06.
Surgical volunteer mission is a well-recognized approach for reducing the burden of surgical disease worldwide. The aim of this study was to evaluate safety and patient satisfaction of thyroid surgery in the context of surgical mission carried out in Bohol Province, Philippines.
This was a prospective study involving consecutive patients undergoing thyroid surgery in the surgical mission held in 2018. Informed consent was obtained from the patients. Safety defined as observed serious postoperative complication rate as compared to its expected based on American College of Surgeons National Surgical Quality Improvement Program (NSQIP) was the primary endpoint, whereas patient satisfaction rated on a 5-point Likert scale was the secondary endpoint. Expected serious complication rate was calculated using the surgical risk calculator of NSQIP. Thyroid surgery included partial resections, hemi-, subtotal, and total thyroidectomies.
Thirty-eight patients underwent thyroidectomy performed by 4 surgeons in 2018 mission. Mean age of the patients was 40.6±11.3 years. Male to female ratio was 2:36. Goiter was the indication for surgery in 33 (86.8%) patients, whereas 5 (13.2%) patients were operated for thyroid malignancy. Postoperative serious complication and reoperation occurred in 1/38 (2.6%) for hematoma on first postoperative day. Expected and observed serious complication rates did not differ (1.1% 2.6%; P=0.385). Ninety-seven percent of patients were satisfied with outcomes of surgery.
This prospective cohort study found thyroid surgery performed within a surgical mission to be safe. Patient satisfaction rate was 97%. Further research is needed to develop and validate patient satisfaction assessment tools in surgical missions.
外科志愿者任务是一种公认的减轻全球外科疾病负担的方法。本研究的目的是评估在菲律宾薄荷省开展的外科任务背景下甲状腺手术的安全性和患者满意度。
这是一项前瞻性研究，纳入了2018年外科任务中连续接受甲状腺手术的患者。获得了患者的知情同意。主要终点是根据美国外科医师学会国家外科质量改进计划（NSQIP）观察到的严重术后并发症发生率与其预期发生率相比，而采用5分李克特量表评定的患者满意度是次要终点。预期严重并发症发生率使用NSQIP的手术风险计算器计算。甲状腺手术包括部分切除术、半甲状腺切除术、次全甲状腺切除术和全甲状腺切除术。
2018年任务中有38例患者接受了4名外科医生进行的甲状腺切除术。患者的平均年龄为40.6±11.3岁。男女比例为2:36。33例（86.8%）患者的手术指征为甲状腺肿，而5例（13.2%）患者因甲状腺恶性肿瘤接受手术。术后第1天因血肿发生严重并发症和再次手术的发生率为1/38（2.6%）。预期和观察到的严重并发症发生率无差异（1.1%对2.6%；P=0.385）。97%的患者对手术结果满意。
这项前瞻性队列研究发现，在外科任务中进行的甲状腺手术是安全的。患者满意度为97%。需要进一步研究以开发和验证外科任务中的患者满意度评估工具。
