Perioperative Management of Gastrointestinal Surgery in a Resource-Limited Hospital in Niger: Cross-sectional Study

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Perioperative Management of Gastrointestinal Surgery in a Resource-Limited Hospital in Niger: Cross-sectional Study


JournalAnnals of Medicine and Surgery
Publication date – Apr – 2020
Authors – Harissou Adamou, Ibrahim Amadou Magagi, Ousseini Adakal, Mahamadou Doutchi, Oumarou Habou, Mamane Boukari, Lassey James Didier, Rachid Sani
Keywordscomplications, Gastrointestinal surgery, Management, Perioperative, Quality of care.
Open access – Yes
SpecialityGeneral surgery
World region Western Africa
Country: Niger
Language – English
Submitted to the One Surgery Index on May 21, 2020 at 7:54 am
Abstract:

Background
Perioperative management in digestive surgery is a challenge in sub-Saharan Africa. Objective: To describe the process and outcomes of perioperative management in gastrointestinal surgery.
Materials and methods
This was a single center cross-sectional study over a 4-month period from June 1 to September 30, 2017, in a Nigerien hospital (West Africa). This study included caregivers and patients operated on gastrointestinal surgery.
Results
We collected data for 56 caregivers and 253 patients underwent gastrointestinal surgery. The average age of caregivers was 38.6 ± 8.7. The median length of professional practice was 9 years. Almost 52% of caregivers (n = 29) did not know the standards of perioperative care. The median age of patients was 24 years, and male gender constituted 70% of cases (n = 177) with a sex ratio of 2.32. Patients came from rural areas in 78.2% (n = 198). Emergency surgery accounted for 60% (n = 152). The most surgical procedure was digestive ostomies performed in 28.9% (n = 73), followed by hernia repair and appendectomy in 24.5% (n = 62) and 13.9% (n = 35) respectively. The postoperative course was complicated in 28.1% (n = 71) among which 13 deaths. In the group of caregivers, the poor practice of perioperative management was associated with poor professional qualification, insufficient equipment, insufficient motivation (p < 0.05). The ASA3&ASA4 score, undernutrition, emergency surgery, poor postoperative monitoring, and poor psychological preparation were associated with complicated postoperative outcomes (p < 0.05).
Conclusion
The inadequacy of the technical platform and the lack of continuous training for healthcare staff represented the main dysfunctions of our hospital. The risk factors for complications found in this study need appropriate perioperative management to improve prognosis in gastrointestinal surgery.

OSI Number – 20394
PMID – 32322389

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