Neurosurgery unit, Department of Surgery, University of Nigeria Ituku/Ozalla Campus, Enugu, Nigeria.
University of Nigeria Teaching Hospital , Ituku/Ozalla Enugu, 40001, Nigeria.
Acta Neurochir (Wien). 2020 May;162(5):973-981. doi: 10.1007/s00701-019-04207-6. Epub 2020 Jan 4.
The unmet need for neurosurgery in sub-Saharan Africa is staggering. Resolving this requires strategies that synergize salient local resources with tailored foreign help. This study is a trial of a twinning model adopted by the Swedish African Neurosurgical Collaboration (SANC).
A multi-step neurosurgical twinning technique, International Neurosurgical Twinning Modeled for Africa (INTIMA), developed through a collaboration between African and Swedish neurosurgical teams was adopted for a neurosurgical mission in March 2019. The pioneering steps are evaluated together with data of treated patients prospectively acquired using SPSS Chicago Inc., Version 23. Associations were analyzed using chi-square tests, while inferences were evaluated at 95% level of significance.
The SANC global neurosurgery mission targeted microsurgical brain tumor resection. Fifty-five patients were operated on during the mission and subsequent 3 months. Patients' ages ranged from 3 months to 69 years with a mean of 30.6 ± 2.1 years 95% CL. Seven cases were performed during the first mission, while 48 were performed after the mission. Compared to 3 months before SANC when only 9 brain tumors were resected, more tumors were resected (n = 25) within the 3 consecutive months from the mission (X = 14.2, DF = 1, P = 0.000). Thirty-day mortality following tumor resection was also lower, X = 4.8, DF = 1, P = 0.028.
Improvements in capacity and short-term outcome define our initial pioneering application of a neurosurgical twinning paradigm pioneered by SANC.
撒哈拉以南非洲地区对神经外科的需求尚未得到满足，这一情况令人震惊。要解决这一问题，需要将当地的重要资源与有针对性的外国援助相结合，制定出协同的策略。本研究是对瑞典非洲神经外科学合作组织（SANC）采用的结对模式的一次尝试。
通过非洲和瑞典神经外科团队之间的合作，开发了一种多步骤的神经外科结对技术，即“面向非洲的国际神经外科结对模型（INTIMA）”，并于 2019 年 3 月在一次神经外科任务中采用。对开创性步骤进行评估，并使用 SPSS Chicago Inc. 版本 23 前瞻性地获取治疗患者的数据。使用卡方检验分析相关性，置信区间为 95%，并在 95%置信水平下评估推断。
SANC 的全球神经外科任务旨在进行显微脑肿瘤切除术。任务期间及随后的 3 个月内共对 55 名患者进行了手术。患者年龄在 3 个月至 69 岁之间，平均年龄为 30.6±2.1 岁，95%置信区间为 30.6±2.1 岁。有 7 例是在第一次任务中进行的，而 48 例是在任务之后进行的。与 SANC 之前的 3 个月相比，当时仅切除了 9 个脑瘤，任务后的 3 个月内切除的肿瘤更多（n=25）（X=14.2，DF=1，P=0.000）。肿瘤切除后的 30 天死亡率也较低，X=4.8，DF=1，P=0.028。
能力的提高和短期结果的改善定义了我们对 SANC 开创的神经外科结对模式的初步开创性应用。
