Al-Hadidi Ameer, Alslaim Hossam, Ghawanmeh Malik, Alfarajat Farah, Habra Hani, Brahmamdam Pavan, Novotny Nathan
Department of General Surgery, Beaumont Health, 3535 W. 13 Mile Rd Ste 307, Royal Oak, MI, 48073, USA.
Department of General Surgery, Medical College of Georgia, Augusta, Georgia.
Pediatr Surg Int. 2020 Aug;36(8):977-981. doi: 10.1007/s00383-020-04667-3. Epub 2020 May 16.
Short-term surgical missions can provide communities in need with desired expertise; however, it is uncertain who will manage the complications after visiting experts leave. Poor outcomes, decreased patient satisfaction, and tension on the healthcare system develop when local providers, often excluded from the initial patient care, are unable to cope with subsequent morbidity.
Two-year retrospective review of pediatric general, plastic, and reconstructive surgery, and urology cases performed by a relief organization in the developing world. Case complexity and postoperative complications were analyzed. Phone interviews conducted with patients/families to quantify postoperative outcomes and satisfaction.
474 surgeries were performed on pediatric patients with 60% response rate. Respondents stratified into three levels of complexity: 159 simple, 72 intermediate, and 54 advanced surgeries. Six (2.1%) high-level complications occurred. No association between the complexity of the surgery and the occurrence of a complications. 83.5% were satisfied with outcomes and > 92% were happy with the provided support.
Facilitating visiting and local surgeons performing cases together increases the expertise of local providers, strengthens infrastructure, and establishes clear follow-up. Despite complications, patients and families continued to recommend care to family and friends by the relief organization and were happy with support from local providers. Engaging local providers is the gold-standard for short-term trips.
短期外科手术任务可为有需要的社区提供所需的专业知识；然而，在来访专家离开后，尚不确定谁将处理并发症。当通常被排除在初始患者护理之外的当地医疗人员无法应对后续发病情况时，就会出现不良后果、患者满意度下降以及医疗系统紧张的情况。
对一个救援组织在发展中世界进行的儿科普通外科、整形外科、重建外科和泌尿外科病例进行为期两年的回顾性研究。分析病例复杂性和术后并发症。对患者/家属进行电话访谈，以量化术后结果和满意度。
对儿科患者进行了474例手术，回复率为60%。受访者分为三个复杂程度级别：159例简单手术、72例中等手术和54例高级手术。发生了6例（2.1%）严重并发症。手术复杂性与并发症的发生之间没有关联。83.5%的人对结果满意，超过92%的人对所提供的支持感到满意。
促进来访外科医生和当地外科医生共同开展手术，可提高当地医疗人员的专业知识，加强基础设施建设，并建立明确的后续跟进措施。尽管出现了并发症，但患者和家属仍继续向家人和朋友推荐该救援组织提供的护理，并对当地医疗人员的支持感到满意。让当地医疗人员参与是短期任务的黄金标准。
