Abstract:
BACKGROUND:Billions of people worldwide lack access to safe affordable surgery. Surgical missions and non-governmental organisations (NGO) are vital in meeting this need, but long-term outcomes are rarely reported. Mercy Ships is a surgical NGO, and we aimed to measure disability-free survival, impact and patient satisfaction in Madagascar after a 7-month mission. METHOD:We aimed to evaluate 346 patients. Primary outcome measure was the World Health Organisation Disability Assessment Schedule 2.0 (WHODAS 2.0); secondary outcomes were residual pain; changes in perception of shame and acceptance by society; and overall satisfaction with surgery. Linear regression used to determine association between covariates and each outcome measure. RESULTS:One hundred patients were uncontactable and 98 failed to attend, leaving 148 for final evaluation at a median duration of 8 months. Median WHODAS 2.0 was 2.1 % (range 0-25 %); 1 patient had a score of 25 % defined as disability. 32/148 had residual pain; average pain score of 1.8/5. Overall patient satisfaction was 4.7/5 (94 %). Median patient shame scores fell from 2.9/5 (58 %) to 0.3/5 (6 %) and median acceptance scores rose from 3.3/5 (66 %) to 4.8/5 (96 %) (both p ≤ 0.001) postoperatively. WHODAS 2.0 significantly correlated with gender and postoperative pain (both p ≤ 0.05). CONCLUSION:Surgical missions have a duty-of-care to evaluate outcomes, and WHODAS 2.0 is a quick, reliable method to ensure surgeries do no harm. Measurements of perception of shame, acceptance by society, patient expectation and satisfaction can also be reliably measured and should not be forgotten by surgical NGOs.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
White M,Alcorn D,Randall K,Duncan S,Klassen H,Shrime Mdoi
10.1007/s00268-016-3745-1subject
Has Abstractpub_date
2017-02-01 00:00:00pages
364-369issue
2eissn
0364-2313issn
1432-2323pii
10.1007/s00268-016-3745-1journal_volume
41pub_type
杂志文章abstract:BACKGROUND:Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying th...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05657-1
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Assessment of preoperative physiological status is crucial for optimizing clinical outcomes in patients undergoing surgery for esophageal carcinoma (EC). We aimed to evaluate the prognostic impact of pulmonary dysfunctions and their relationships with other physiological factors, especially sarcopenia, in EC...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-020-05450-0
更新日期:2020-07-01 00:00:00
abstract:BACKGROUND:As more patients undergo diagnostic thyroid surgery, the development of posthemithyroidectomy hypothyroidism is becoming a major concern. We hypothesized that the preoperative thyrotropin (thyroid-stimulating hormone, TSH) level and ultrasonographically measured thyroid volume, both commonly available in thy...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9717-3
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:A recent analysis found bradycardia during laparoscopy as a potential early warning sign of cardiac arrest. Knowledge regarding bradycardia frequency and its consequences during laparoscopy is limited. METHODS:Using the computerized record database, files of 9915 patients undergoing laparoscopic surgery, be...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-04935-x
更新日期:2019-06-01 00:00:00
abstract:BACKGROUND:Few details of the clinical features of hepatocellular carcinoma (HCC) developing extrahepatic recurrence after a curative resection have been published. The purpose of this study was to clarify the clinicopathologic findings of patients with HCC who experienced extrahepatic metastases. METHODS:Clinicopatho...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9613-x
更新日期:2008-08-01 00:00:00
abstract:BACKGROUND:The purpose of the present study was to analyze the risk multi-factors of postoperative cardiac arrhythmia for elderly patients with esophageal or cardiac carcinoma. METHODS:A total of 756 operations for elderly patients (>65 years of age) with esophageal or cardiac carcinoma were performed in our departmen...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0222-0
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The adoption of robotic systems for gastric cancer surgery has been proven feasible and safe; however, a benefit over the laparoscopic approach has not yet been well-documented. We aimed to investigate the surgical outcomes of robotic versus laparoscopic gastrectomy for gastric cancer, according to the exten...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2998-4
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:The appropriate surgical approach for hepatocellular carcinoma (HCC) patients of Child-Pugh class B is unclear. The aim of this study was to clarify the prognostic factors after hepatectomy in Child-Pugh class B patients and to delineate the selection criteria for hepatectomy. METHODS:One hundred fifty pati...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-010-0929-y
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:Rectus sheath hematoma is rare. It can present to physicians in many specialties, but invariably the surgeon is contacted regarding management. It is frequently difficult to diagnose, which can result in delay of treatment or unnecessary surgery. Its incidence is on the rise. METHODS:We present a series o...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-005-0702-9
更新日期:2006-11-01 00:00:00
abstract:BACKGROUND:Patients with HIV/AIDS on antiretroviral therapy (ART) live longer and now require surgery for indications similar to those described for the general population. They have been previously reported to carry higher mortality and complication rates, especially septic complications. The aim of this study was to ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-015-2994-8
更新日期:2015-07-01 00:00:00
abstract::This study investigated whether cytokines and colony-stimulating factors can predict prognosis in patients with postoperative multiple organ failure (MOF). We evaluated 14 patients with postoperative MOF who underwent operation for cardiovascular disease. Seven patients recovered from MOF (survivors) and seven did not...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002689900520
更新日期:1998-10-01 00:00:00
abstract::The pathogenesis of pain in chronic pancreatitis remains an enigma. The cause of pain is almost certainly multifactorial and may vary at different stages of the disease process. These factors may include the release of excessive oxygen-derived free radicals, tissue hypoxia and acidosis, inflammatory infiltration with ...
journal_title:World journal of surgery
pub_type: 杂志文章,评审
doi:10.1007/s00268-003-7235-x
更新日期:2003-11-01 00:00:00
abstract:BACKGROUND:The risk of developing chronic kidney disease (CKD) among living kidney donors (LKDs) is seldom included in evaluations of patients' outcomes. Potential risk factors and new criteria for estimating the glomerular filtration rate (eGFR) indexed for body surface area (BSA) were investigated with a view to prev...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-013-1906-z
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:The reported high incidence of 30-60% postoperative pain after an elective day surgical orchidopexy is undesirable. We evaluated the efficacy of our analgesic regimen for unilateral orchidopexy in preschool children performed as a day surgical procedure. METHODS:Between January 2004 and December 2006, 247 c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-008-9847-7
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Laparoscopic incisional and ventral hernia repair (LIVHR) is an alternative approach to conventional open incisional and ventral hernia repair (OIVHR). A consensus on outcomes of LIVHR when compared with OIVHR has not been reached. METHODS:As the basis for the present study, we performed a systematic review...
journal_title:World journal of surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00268-014-2578-z
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Molecular diagnostics can allow some patients with indeterminate thyroid nodule cytopathology to avoid diagnostic hemithyroidectomy; however, the testing is costly. We hypothesized that molecular testing with the intention of preventing unnecessary diagnostic hemithyroidectomy would be cost-effective if this...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-019-05177-7
更新日期:2020-02-01 00:00:00
abstract::The surgical treatment of 30 cases of vascular thoracic outlet syndrome (TOS) in 25 patients is presented. Patients included 17 women and 8 men with average age of 26.1 years. The causes of compression were cervical rib ( n = 16), soft tissue anomalies ( n = 12), and scar tissue after clavicle fracture ( n = 2). Ten s...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-003-6808-z
更新日期:2003-05-01 00:00:00
abstract::In a prospective multicenter study, 186 patients with squamous cell esophageal carcinoma, who after evaluation were considered suitable for surgery, were randomized to 4 treatment groups: Group 1, surgery alone; Group 2, pre-operative chemotherapy (cisplatin and bleomycin) and surgery; Group 3, pre-operative irradiati...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1007/BF02067069
更新日期:1992-11-01 00:00:00
abstract::In some patients, bile ducts of segments 2 and 3 (B2 and B3) run caudally to the umbilical portion of the left portal vein (UP)--an infraportal course. We aimed to evaluate the frequency and clinical implications of this variation. Between January 1992 and October 2000, 108 patients underwent resection for hilar chola...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-002-6544-9
更新日期:2002-12-01 00:00:00
abstract::Thoracic and thoracoabdominal penetrating wounds are frequently encountered in urban medical centers in the United States. This study was undertaken to determine the clinical characteristics and in hospital outcome of these injuries. This was a longitudinal, nonblinded study using the established standard of care of p...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF03215862
更新日期:2001-09-01 00:00:00
abstract:BACKGROUND:The aim of the present study was to investigate the incidence of sleep disturbance and insomnia in patients with primary hyperparathyroidism (PHPT), and to evaluate the effect of parathyroidectomy. METHODS:A questionnaire was prospectively administered to adult patients with PHPT who underwent curative para...
journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
doi:10.1007/s00268-013-2285-1
更新日期:2014-03-01 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:BACKGROUND:Hepatic resection for hepatocellular carcinoma (HCC) patients with liver cirrhosis and severe hypersplenic thrombocytopenia is risky and controversial. METHODS:From 1989 to 2005, 341 patients underwent hepatic resection for HCC in our hospital. Of these, 15 patients were concomitant with severe thrombocytop...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-007-9442-3
更新日期:2008-06-01 00:00:00
abstract::This study aimed (1) to develop a simple scoring system incorporating ultrasound (US) examination and clinical or laboratory predictors for increasing diagnostic accuracy in acute appendicitis (AA), and (2) to evaluate the performance of the scoring system as compared to that of previous models. Fifteen variables incl...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-7853-6
更新日期:2005-09-01 00:00:00
abstract:INTRODUCTION:The follicular variant of papillary thyroid carcinoma (FVPTC) is the most common histologic subtype of papillary thyroid carcinoma (PTC). However, it is still controversial whether FVPTC should behave differently from classical PTC (CPTC). The present study aimed at evaluating any potential difference in c...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-005-0356-7
更新日期:2006-05-01 00:00:00
abstract::This study aims to examine the frequency of the pheochromocytoma (pheo), defined as a "benign, intra-adrenal, hypertensive, sporadic, unilateral tumor." Three large series amounting to 310 subphrenic chromaffin tumors operated over periods of 17, 23, and 41 years, respectively, have been reviewed. Among those combined...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/BF00353738
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Self-expanding metallic stents (SEMS) have been used as a bridge to surgery in patients with obstruction by colorectal cancer, but the oncologic safety of this technique has not yet been established. The aim of the present study was to compare the outcomes of bridge to surgery after SEMS insertion and nonobs...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-009-0007-5
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Hernia is especially prevalent in developing countries where the population is obliged to undertake strenuous work in order to survive, and International Cooperation Programmes are helping to solve this problem. However, the quality of surgical interventions is unknown. The objective of the present study was...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-012-1768-9
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Anastomotic leakage is a serious clinical problem after colorectal resections and is associated with a significantly increased length of stay, morbidity and mortality. The aim of the present study was to evaluate the effect of changes in clinical practice on anastomotic leakage rate after colorectal resectio...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s00268-017-4423-7
更新日期:2018-07-01 00:00:00
abstract::Percutaneous dilatational tracheostomy (PDT) is being increasingly used. Concerns have been raised as to its safety, especially when it is done at the bedside. A prospective evaluation was conducted of 100 consecutive, unselected critically ill patients with PDT. The mean intensive care unit (ICU) stay before PDT was ...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/s002680010180
更新日期:2000-09-01 00:00:00