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在尼日利亚农村一家教学医院开展腹腔镜手术的早期经验。

Early Experience of Laparoscopic Surgery in a Teaching Hospital in Rural Nigeria.

机构信息

Department of Surgery, Babcock University Teaching Hospital, Ilisan, Ogun State, Nigeria.

Department of Anaesthesia, Babcock University Teaching Hospital, Ilisan, Ogun State, Nigeria.

出版信息

West Afr J Med. 2022 May 27;39(5):516-520.

Abstract

INTRODUCTION/BACKGROUND: Laparoscopic surgery is still at its budding phase in low resource countries. The reasons for this include poor financing of the health sector and lack of trained personnel. The aim of this article is to highlight our initial experiences, our challenges in setting up laparoscopic surgery in a private tertiary hospital in rural southwestern Nigeria, and to share our efforts towards alleviating these challenges.

METHODOLOGY

A retrospective analysis of all patient who had laparoscopic surgery between January 2019 and December 2020 at the Surgery Department of Babcock University Teaching Hospital, Ilisan, Ogun State was carried out. Their sociodemographic, preoperative and intraoperative data along with postoperative records were subjected to descriptive analysis.

RESULTS

During the period, 19 patients had laparoscopic procedures: 12(63.2%) males and 7 (36.8%) females with age ranging from 4 to 63years. The most common indication for laparoscopic surgery was appendicitis, representing 84.2% of the procedures. Most of the procedures were done on emergency basis (63.1%) while 36.9% were elective procedures. All the procedures were therapeutic though in 21.1% we started with diagnostic intent but intra-operatively we proceed to therapeutic procedure following confirmation of the diagnosis. The duration of the procedures ranged from 40 minutes to 107 minutes with a mean duration of 74.8±19 minutes. No intra or post operative complications were recorded in this cohort of patients. The mean duration of hospital stay was 2 days.

CONCLUSION

Laparoscopic surgery is safe and feasible in low resource setting. We recommend that centers embarking on laparoscopic surgeries should start with diagnostic procedures and gradually incorporate therapeutic procedures as they improve in proficiency.

摘要

简介/背景:腹腔镜手术在资源匮乏的国家仍处于起步阶段。造成这种情况的原因包括卫生部门资金不足和缺乏训练有素的人员。本文旨在强调我们在尼日利亚西南部农村的一家私立教学医院开展腹腔镜手术方面的初步经验、所面临的挑战,并分享我们为缓解这些挑战所做的努力。

方法

对 2019 年 1 月至 2020 年 12 月在巴博克大学教学医院外科部进行腹腔镜手术的所有患者进行回顾性分析。对他们的社会人口统计学、术前和术中数据以及术后记录进行描述性分析。

结果

在此期间,19 名患者接受了腹腔镜手术:12 名(63.2%)男性和 7 名(36.8%)女性,年龄在 4 至 63 岁之间。腹腔镜手术最常见的指征是阑尾炎,占手术的 84.2%。大多数手术是在紧急情况下进行的(63.1%),而 36.9%是择期手术。所有手术都是治疗性的,尽管有 21.1%的手术我们最初是出于诊断目的,但在术中确认诊断后,我们会转为治疗性手术。手术时间从 40 分钟到 107 分钟不等,平均时间为 74.8±19 分钟。在这组患者中,没有记录到任何术中或术后并发症。患者的平均住院时间为 2 天。

结论

腹腔镜手术在资源匮乏的环境中是安全可行的。我们建议,开展腹腔镜手术的中心应从诊断性手术开始,并随着熟练度的提高逐渐纳入治疗性手术。

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