Nyundo Martin, Kayondo King, Gasakure Miguel, Urimubabo Jean Christian, Houben Jean Jacques, Limgba Augustin, Nifasha Antoine, Gashegu Julien, Detry Olivier
Department of Surgery, University Teaching Hospital of Kigali, University of Rwanda, Rwanda.
Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda.
Surg Open Sci. 2023 Sep 12;15:67-72. doi: 10.1016/j.sopen.2023.09.008. eCollection 2023 Sep.
Laparoscopic surgery is the gold standard for many abdominal surgeries. Laparoscopic programs in low- and middle-income countries (LMICs) and in sub-Saharan Africa face many constraints, although its use is safe, feasible, and clinically beneficial. The authors assessed patient-reported outcomes and the experience of patients operated on at the University Teaching Hospital of Kigali (CHUK).
This is a retrospective cross-sectional study combining medical data from medical files and information collected from telephone calls to 288 patients who underwent laparoscopic cholecystectomy at CHUK from January 2015 to December 2020.
Among 446 laparoscopic surgeries performed at CHUK over 6 years, cholecystectomies accounted for 64.6 % of cases (288/446). Postoperative complications and mortality after laparoscopic cholecystectomy were low, respectively 1.7 % and 0.7 %, while the median length of stay was 3 days. About 74 % of surveyed patients had never heard of laparoscopic surgery prior to their procedure. Knowledge of laparoscopic surgery was associated with patient education level (p < 0.001). Half of patients had not been involved in the choice of the surgical technique. Overall satisfaction was over 95 % and >90 % of patients consider laparoscopic surgery as the best surgical approach in Rwanda, and for this reason they declared to be ready to promote this new technology despite its higher cost. However, patients reported some weaknesses and made recommendations for improving public awareness of laparoscopy and its benefits, patient-provider relationships, training of surgical workforce, laparoscopic equipment, and infrastructure.
Laparoscopic cholecystectomy can be performed with a low rate of postoperative complications in a resource-limited setting like Rwanda. Patient satisfaction was high, but efforts should be made to improve public awareness of laparoscopic surgery, improve surgical capacity, laparoscopic equipment, and infrastructure.
腹腔镜手术是许多腹部手术的金标准。低收入和中等收入国家（LMICs）以及撒哈拉以南非洲的腹腔镜手术项目面临诸多限制，尽管其使用安全、可行且具有临床益处。作者评估了患者报告的结局以及在基加利大学教学医院（CHUK）接受手术的患者的体验。
这是一项回顾性横断面研究，结合了医疗档案中的医疗数据以及通过电话对2015年1月至2020年12月在CHUK接受腹腔镜胆囊切除术的288例患者收集的信息。
在CHUK六年内进行的446例腹腔镜手术中，胆囊切除术占病例的64.6%（288/446）。腹腔镜胆囊切除术后的术后并发症和死亡率较低，分别为1.7%和0.7%，而中位住院时间为3天。约74%的接受调查患者在手术前从未听说过腹腔镜手术。对腹腔镜手术的了解与患者教育水平相关（p<0.001）。一半的患者未参与手术技术的选择。总体满意度超过95%，超过90%的患者认为腹腔镜手术是卢旺达最好的手术方法，因此他们表示尽管成本较高，仍愿意推广这项新技术。然而，患者报告了一些不足之处，并就提高公众对腹腔镜检查及其益处的认识、患者与提供者的关系、外科手术人员的培训、腹腔镜设备和基础设施提出了建议。
在卢旺达这样资源有限的环境中，腹腔镜胆囊切除术可以在术后并发症发生率较低的情况下进行。患者满意度较高，但应努力提高公众对腹腔镜手术的认识，提高手术能力、腹腔镜设备和基础设施水平。
