Abstract:
BACKGROUND:Significant barriers limit the safe and timely provision of surgical and anaesthetic care in low- and middle-income countries. Nearly one-half of Mongolia's population resides in rural areas where the austere geography makes travel for adequate surgical care very difficult. Our goal was to characterize the availability of surgical and anaesthetic services, in terms of infrastructure capability, physical resources (supplies and equipment), and human resources for health at primary level health facilities in Mongolia. METHODS:A situational analysis of the capacity to deliver emergency and essential surgical care (EESC) was performed in a nonrandom sample of 44 primary health facilities throughout Mongolia. RESULTS:Significant shortfalls were noted in the capacity to deliver surgical and anesthetic services. Deficiencies in infrastructure and supplies were common, and there were no trained surgeons or anaesthesiologists at any of the health facilities sampled. Most procedures were performed by general doctors and paraprofessionals, and occasionally visiting surgeons from higher levels of the health system. While basic interventions such as suturing or abscess drainage were commonly performed, the availability of many essential interventions was absent at a significant number of facilities. CONCLUSIONS:This situational analysis of the availability of essential surgical and anesthetic services identified significant deficiencies in infrastructure, supplies, and equipment, as well as a lack of human resources at the primary referral level facilities in Mongolia. Given the significant travel distances to secondary level facilities for the majority of the rural population, there is an urgent need to strengthen the delivery of essential surgical and anaesthetic services at the primary referral level (soum and intersoum). This will require a multidisciplinary, multi-sectoral effort aimed to improve infrastructure, procure and maintain essential equipment and supplies, and train appropriate health professionals.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Spiegel DA,Choo S,Cherian M,Orgoi S,Kehrer B,Price RR,Govind Sdoi
10.1007/s00268-010-0904-7subject
Has Abstractpub_date
2011-02-01 00:00:00pages
272-9issue
2eissn
0364-2313issn
1432-2323journal_volume
35pub_type
杂志文章abstract::The eponym "Graves' disease" is usually applied to the condition of immunogenic hyperthyroidism, in no small part due to the promotion and influence of the French physician Armand Trousseau who wrote in 1862, "Du Goître Exophthalmique, ou Maladie de Graves." However, the distinguished Bath physician Caleb Hillier Parr...
journal_title:World journal of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1007/s00268-009-0297-7
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Burns are a major public health concern, affecting mostly low- and middle-income countries. However, there is a lack of epidemiological studies on burns in these countries, particularly in Latin American countries. Our aim was to analyze nationwide demographic, epidemiological and economic characteristics of...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-3988-5
更新日期:2017-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4121-5
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Whilst injuries are a major cause of disability and death worldwide, a large proportion of people in low- and middle-income countries lack timely access to injury care. Barriers to accessing care from the point of injury to return to function have not been delineated. METHODS:A two-day workshop was held in ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05571-6
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Esophagectomy carries high morbidity, mainly respiratory. Minimally invasive surgery has been demonstrated to improve postoperative outcome in digestive surgery, without impairment of oncological results. A prospective study was conducted to evaluate feasibility, postoperative outcome, and mid-term oncologic...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0627-3
更新日期:2006-08-01 00:00:00
abstract:BACKGROUND:The aim of the study was to compare the changes in health-related quality of life (QOL) after lung surgery between young and old patients. METHODS:We performed a prospective, population-based, cohort study to investigate health-related QOL before and 6 months after lung surgery. We used the validated instru...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0430-7
更新日期:2010-04-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-006-0693-1
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Despite curative resection, hepatocellular carcinoma (HCC) has a high probability of recurrence. We validated the potential role of liver resection (LR) for recurrent HCC. METHODS:Patients with intrahepatic recurrence with up to three lesions were included. We compared survival times of patients undergoing ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05225-2
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Neoadjuvant chemotherapy (NC) is standard therapy for patients with locally advanced breast cancer and is increasingly used for early-stage operable disease. Clinical and pathological responses are important prognostic parameters for NC, which aims to achieve a pathological complete response or tumor reducti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9800-9
更新日期:2009-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,评审
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更新日期:2013-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-03-01 00:00:00
abstract::The measurement of the burden of disease and the interventions that address that burden can be done in various units. Reducing these measures to the common denominator of economic units (i.e., currency) enables comparison with other health entities, interventions, and even other fields. Economic assessment is complex,...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1796-5
更新日期:2013-07-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0377-8
更新日期:2010-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-016-3442-0
更新日期:2016-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4614-x
更新日期:2018-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05165-x
更新日期:2019-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9115-2
更新日期:2007-08-01 00:00:00
abstract:BACKGROUND:This is a baseline assessment of surgical capacity in the Federal Capital Territory (FCT), in preparation for the creation of a National Surgical, Obstetric, Anesthesia, and Nursing Plan. METHODS:In October 2017, all 10 of the 11 secondary hospitals in FCT that provide surgical and/or obstetric care were su...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4835-z
更新日期:2019-03-01 00:00:00
abstract:BACKGROUND:This study was undertaken to determine the efficacy of the clinical indications for performing staging laparoscopy for locally advanced gastric cancer to detect peritoneal metastasis or positive cytology findings. METHODS:The study included 231 patients with T4 gastric cancer without hematogenous or clinica...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1290-5
更新日期:2011-12-01 00:00:00
abstract::The effects of pneumoperitoneum on the lower esophageal sphincter (LES) were evaluated during laparoscopic operation for esophageal achalasia. Intraoperative manometry was performed in three patients who underwent laparoscopic cardiomyectomy with Dor's fundoplication and five patients who underwent laparoscopic cholec...
journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1996-10-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0322-x
更新日期:2010-03-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05382-9
更新日期:2020-05-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9704-8
更新日期:2008-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01658968
更新日期:1991-01-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9404-9
更新日期:2008-06-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689910007
更新日期:2000-01-01 00:00:00
abstract::A variety of techniques have been used for surgical treatment of hepatic hydatid cysts. The objective of this study is to describe the technique of diaphragm myoplasty, and to present our experience in the treatment of selected patients with hydatid disease of the liver by means of this alternative surgical technique....
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6558-3
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:The treatment of acute limb ischemia (ALI) has barely changed over the last years. However, the progressive implementation of anticoagulants, antiplatelet agents or statins within the population might have modified the profile and prognosis of patients suffering an ALI. The aim of this study was to evaluate ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4511-3
更新日期:2018-08-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-009-0144-x
更新日期:2009-09-01 00:00:00
abstract:BACKGROUND:Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder for which appropriate diagnostic treatments are uncertain. The response to splenectomy varies from 60% to 90%, and the remaining patients relapse and require further treatment. Therefore, it is important to predict the outcome of splenectomy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7964-0
更新日期:2006-04-01 00:00:00