Obonna G C, Etonyeaku A C, Katung I A, Bamigbola K T, Okereke C E
Department of Surgery, University of Medical Sciences, Medical village Ondo City, Ondo State, Southwestern Nigeria.
Department of Surgery Obafemi Awolowo University/ Obafemi Awolowo University Teaching Hospitals Complex Ile-Ife Osun State, Southwestern, Nigeria.
West Afr J Med. 2020 Apr-Jun;37(2):183-188.
Laparoscopic surgery is a relatively new and expanding field of surgical therapy in Ondo state. This is a multi-centre study cataloguing the work of the authors in Ondo State, Nigeria.
To determine the indications, operative findings, and interventions at Laparoscopy in our resource challenged settings.
Medical records of all patients who had laparoscopic procedure at the Federal Medical Centre, Owo, Ondo State Specialist hospital, Okitipupa, University of Medical Sciences Teaching Hospital, Ondo, George and Martins Medical Centre, Ore and Mishmael Hospitals and Clinics, Akure from December, 2009 to December, 2018 were reviewed. Data on patient's age, gender, indications for surgery, duration of hospital stay, outcome of surgery were analyzed. Challenges and adaptations were also noted.
One hundred and eighty-one (181) laparoscopic procedures were done, but only 152 had complete records for review. The median age was 35.5 years (mean = 33.7±11.4years; age range of 8 month -72 years). There were more males 88(57.9%) than females, 64(42.1%). Laparoscopy was purely diagnostic (n=28,18.4%), therapeutic (n=118, 77.6%) or both (n=6, 3.9%). Cholecystectomy (n=76, 50%) and appendicectomy (n=37, 24.3%) were the two most common procedures done. In the paediatric patients, patent processus vaginalis (hernia), cryptorchidism and indeterminate sex (gender) were common indication. Challenges encountered were power failure (n=3, 2%), equipment failure (n=4, 2.6%) and difficult dissection (n=4, 2.6%). The mean duration of surgery was 96.96(±25) minutes (diagnostic), 150 (±57.6) minutes (therapeutic); while the mean duration of hospital stay was one day (diagnostic) and 2.3(±1.7) days for therapeutic interventions.
Laparoscopic service is achievable with adequate motivation, males appear to benefit more in our setting, and the service transcends all aged groups.
腹腔镜手术在翁多州是一个相对较新且不断发展的外科治疗领域。这是一项多中心研究，记录了作者们在尼日利亚翁多州的工作。
确定在我们资源有限的环境中腹腔镜检查的适应症、手术发现及干预措施。
回顾了2009年12月至2018年12月期间在翁多州奥沃联邦医疗中心、奥基蒂普帕翁多州立专科医院、翁多医学科学大学教学医院、奥雷乔治和马丁斯医疗中心以及阿库雷州米什梅尔医院及诊所接受腹腔镜手术的所有患者的病历。分析了患者的年龄、性别、手术适应症、住院时间、手术结果等数据。还记录了遇到的挑战及应对措施。
共进行了181例腹腔镜手术，但只有152例有完整记录可供回顾。中位年龄为35.5岁（平均=33.7±11.4岁；年龄范围为8个月至72岁）。男性88例（57.9%）多于女性64例（42.1%）。腹腔镜检查纯粹为诊断性的（n=28，18.4%）、治疗性的（n=118，77.6%）或两者兼具（n=6，3.9%）。胆囊切除术（n=76，50%）和阑尾切除术（n=37，24.3%）是最常进行的两种手术。在儿科患者中，鞘状突未闭（疝气）、隐睾症和性别不明是常见适应症。遇到的挑战包括停电（n=3，2%）、设备故障（n=4，2.6%）和困难的解剖（n=4，2.6%）。诊断性手术的平均时长为96.96（±25）分钟，治疗性手术为150（±57.6）分钟；诊断性手术的平均住院时间为1天，治疗性干预为2.3（±1.7）天。
通过充分的积极性可实现腹腔镜服务，在我们的环境中男性似乎受益更多，且该服务涵盖所有年龄组。
