Abstract:
BACKGROUND:There is increasing interest in provision of essential surgical care as part of public health policy in low- and middle-income countries (LMIC). Relatively simple interventions have been shown to prevent death and disability. We reviewed the published literature to examine the cost-effectiveness of simple surgical interventions which could be made available at any district hospital, and compared these to standard public health interventions. METHODS:PubMed and EMBASE were searched using single and combinations of the search terms "disability adjusted life year" (DALY), "quality adjusted life year," "cost-effectiveness," and "surgery." Articles were included if they detailed the cost-effectiveness of a surgical intervention of relevance to a LMIC, which could be made available at any district hospital. Suitable articles with both cost and effectiveness data were identified and, where possible, data were extrapolated to enable comparison across studies. RESULTS:Twenty-seven articles met our inclusion criteria, representing 64 LMIC over 16 years of study. Interventions that were found to be cost-effective included cataract surgery (cost/DALY averted range US$5.06-$106.00), elective inguinal hernia repair (cost/DALY averted range US$12.88-$78.18), male circumcision (cost/DALY averted range US$7.38-$319.29), emergency cesarean section (cost/DALY averted range US$18-$3,462.00), and cleft lip and palate repair (cost/DALY averted range US$15.44-$96.04). A small district hospital with basic surgical services was also found to be highly cost-effective (cost/DALY averted 1 US$0.93), as were larger hospitals offering emergency and trauma surgery (cost/DALY averted US$32.78-$223.00). This compares favorably with other standard public health interventions, such as oral rehydration therapy (US$1,062.00), vitamin A supplementation (US$6.00-$12.00), breast feeding promotion (US$930.00), and highly active anti-retroviral therapy for HIV (US$922.00). CONCLUSIONS:Simple surgical interventions that are life-saving and disability-preventing should be considered as part of public health policy in LMIC. We recommend an investment in surgical care and its integration with other public health measures at the district hospital level, rather than investment in single disease strategies.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Grimes CE,Henry JA,Maraka J,Mkandawire NC,Cotton Mdoi
10.1007/s00268-013-2243-ysubject
Has Abstractpub_date
2014-01-01 00:00:00pages
252-63issue
1eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract::The purpose of this study was to elucidate the function of the sphincter of Oddi (SO) in patients with juxtapapillary duodenal diverticula (JDDs). The SO function was evaluated by intraoperative biliary manometry in three groups of patients. Group 1 consisted of nine patients with JDDs and a dilated common bile duct (...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00308647
更新日期:1995-03-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to evaluate the efficacy of 10 % sucralfate ointment in the reduction of acute postoperative pain after open hemorrhoidectomy. METHODS:A total of 48 patients (24 men and 24 women) between 20 and 70 years of age who underwent open hemorrhoidectomy were included in this prospe...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-012-1805-8
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Trauma in the elderly (≥ 55 years) accounts for a significant proportion of admissions to trauma centers. Our understanding of the epidemiology and outcomes associated with penetrating injury in this age segment of the population, however, is severely limited. The aim of the present study therefore was to in...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0920-7
更新日期:2011-03-01 00:00:00
abstract:INTRODUCTION:Preventing secondary insult to the brain is imperative following traumatic brain injury (TBI). Although TBI does not preclude nonoperative management (NOM) of splenic injuries, development of hypotension in this setting may be detrimental and could therefore lead trauma surgeons to a lower threshold for op...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-018-4494-0
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVE:Gastroesophageal reflux disease (GERD) symptoms are commonly reported in primary hyperparathyroidism (pHPT). Although a calcium-mediated cause-and-effect relationship has been suggested, it remains unknown if parathyroidectomy improves GERD symptoms. METHODS:Over a 22-month period, 1,175 (39%) of 3,000 conse...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2876-5
更新日期:2015-03-01 00:00:00
abstract::Individuals in clinical training programs concerned with critical medical care must learn to manage clinical cases effectively as a member of a team. However, practice on live patients is often unpredictable and frequently repetitive. The widely substituted alternative for real patients-high-fidelity, manikin-based si...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9354-2
更新日期:2008-02-01 00:00:00
abstract::With the recent regulations limiting resident work hours, it has become more important to understand how residents spend their time. The volume and content of the pages they receive provide a valuable source of information that give insight into their workload and help identify inefficiencies in hospital communication...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0740-9
更新日期:2010-11-01 00:00:00
abstract::The aim of this study was to identify the risk factors for bacterial translocation and to determine the clinical significance of bacterial translocation in patients with colorectal cancer. Mesenteric lymph node sampling was performed to identify the presence of bacterial translocation in 75 patients with colorectal ca...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7576-0
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Surgery is the best treatment for primary GIST and may be curative, but resection extension/completeness impact on the prognosis remains controversial. The authors aim was to evaluate the clinicopathological (CP) parameters and surgical margins status influence on GIST patients' outcome. MATERIALS AND METHO...
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
abstract:BACKGROUND:Increasing numbers of patients are treated by robotic distal gastrectomy (RDG); however, it remains unclear whether RDG is clinically comparable with conventional laparoscopic distal gastrectomy (LDG). This study aimed to clarify the feasibility of RDG from safety aspects. METHODS:The study included 109 cT1...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4345-4
更新日期:2018-06-01 00:00:00
abstract::The purpose of this study was to evaluate the pattern of recovery of intestinal motility using manometric and clinical assessment in the postoperative ileus following abdominal surgery. We reviewed the charts of 18 patients who underwent partial colectomy for colon cancer (group A, without vagotomy) and compared them ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900310
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:The decision to proceed to simple underwater seal drainage or apply active suction to the underwater seal after lung resection is mostly based on surgeon preference. The purpose of this study was to test whether routine application of active suction is necessary after lobectomy. PATIENTS AND METHODS:This wa...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00268-008-9741-3
更新日期:2008-11-01 00:00:00
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::The aim of this study was to investigate the collagen matrix in recurrent inguinal hernias. Total ribonucleic acid (RNA) was extracted from skin fibroblasts of three groups (control group I = healthy skin; control group II = plain skin scar; recurrent inguinal hernia group = skin of recurrent inguinal hernias; each n ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-001-0239-5
更新日期:2002-04-01 00:00:00
abstract:BACKGROUND:The postoperative functional advantages of a proximal gastrectomy over a total gastrectomy remain debatable. The aim of this study was to evaluate the functional outcomes of a proximal gastrectomy with jejunal interposition (PG-JI), compared with those for a total gastrectomy with Roux-en-Y esophagojejunosto...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-3180-8
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Video-assisted thoracoscopic surgery (VATS) is a new area of exploration and evolution in thoracic minimal invasive surgery. The uniportal VATS approach has become popular during lung resection for small nodules and ground glass lesions. Our objective is to investigate the efficacy, availability and safety o...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05781-y
更新日期:2021-01-01 00:00:00
abstract::A review of the literature describing the management of hepatic and splenic injuries indicates that as many as 67% of exploratory celiotomies for blunt trauma are reported as nontherapeutic. Avoiding unnecessary surgery through nonoperative management offers an attractive alternative. Nonetheless, nonoperative managem...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-001-0138-9
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND:The purposes of this study were to determine clinical presentations and surgical outcomes of perforated peptic ulcer (PPU), and to evaluate the accuracy of the Boey scoring system in predicting mortality and morbidity. METHODS:We carried out a retrospective study of patients undergoing emergency surgery for...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9796-1
更新日期:2009-01-01 00:00:00
abstract::Knowledge of how factors related to esophageal cancer resection affect long-term quality of life after surgery is scarce, and no population-based studies are available. Therefore, we conducted a Swedish nationwide, prospective, population-based study of how esophageal surgery-related factors influence quality of life ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7887-9
更新日期:2005-07-01 00:00:00
abstract:INTRODUCTION:Despite formal definitions of mucinous cystic neoplasms (MCNs) and intraductal papillary neoplasms (IPMNs) by the World Health Organization (WHO) and Armed Forces Institute of Pathology (AFIP), several controversies with regard to MCNs remain. The aim of this review was to determine the clinicopathological...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-006-0126-1
更新日期:2006-12-01 00:00:00
abstract::The aim of this study was to evaluate prognostic factors after the recurrence of hepatocellular carcinoma (HCC) in patients who had undergone hepatic resection. We used univariate and multivariate retrospective analyses of 29 clinicopathologic factors in 143 patients with recurrent HCC. Patients were classified into f...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-004-7205-y
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Intestinal epithelial cell apoptosis has been reported in sepsis as a mechanism of organ failure. The aim of this study was to clarify the role of apoptosis-regulating proteins (bcl-2, bax, cytochrome-c, and caspase-8) in septic rats by studying their expression in gastric and intestinal epithelial cells. M...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0742-1
更新日期:2007-04-01 00:00:00
abstract::A new technique for ligating vessels and similar structures that offers more security is described. The aim of the study was to test whether this hypothesis was correct. Six different types of knots, including the one described in this article were compared by a strength-testing study. The knots were tied on a silicon...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-7675-6
更新日期:2005-10-01 00:00:00
abstract::Node dissection for melanoma remains the most important therapeutic decision for the optimal management of the patient with melanoma. In Australia and in some parts of the United States, the majority of patients with intermediate thickness melanoma (1.6-4.00 mm) will undergo elective lymph node dissection. In Europe, ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:
更新日期:1992-03-01 00:00:00
abstract::Four cases of H-type tracheoesophageal fistula are reported. The patients all had chronic aspiration from the esophagus. Although serious symptoms were present in all, definitive diagnoses were not made until the patients had reached 1, 6, 12, and 50 years of age, because ordinary radiologic methods failed to establis...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF01654780
更新日期:1979-09-20 00:00:00
abstract:BACKGROUND:The goal of this study was to evaluate the outcome of patients who had the Nuss procedure for repair of pectus excavatum. METHODS:Thirty-nine patients (26 male, 13 female) of 61 (63.9%) who had bar removal after the Nuss procedure agreed to participate in an interview. All patients and their parents were as...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-011-1111-x
更新日期:2011-07-01 00:00:00
abstract:BACKGROUND:Superficial soft tissue sarcomas (sSTS) are an important and frequent subtype of soft tissue sarcoma (STS). A wider knowledge of this tumor type may lead to better strategies in tumor therapy. METHODS:An institutional review was performed on all patients with primary sSTS of the extremities and trunk operat...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0051-1
更新日期:2009-08-01 00:00:00
abstract:BACKGROUND:Classification of the open abdomen (OA) status is essential for clinical studies on the subject and may help to improve OA therapy. This is a validity and reliability analysis of the OA classification proposed by the World Society of the Abdominal Compartment Syndrome in 2013. METHODS:Prospective data on 11...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-014-2716-7
更新日期:2014-12-01 00:00:00
abstract::In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF02393582
更新日期:1980-01-01 00:00:00
abstract:BACKGROUND:Several studies have demonstrated that laparoscopic surgery is safe and effective for urgent and emergent colectomy in adulthood. The aim of the present study was to evaluate the feasibility of laparoscopic colectomy for children in emergent settings. METHODS:Between March 2008 and August 2011, 10 consecuti...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1585-1
更新日期:2012-08-01 00:00:00