Abstract：
BACKGROUND:Existing data suggest a large burden of surgical conditions in low- and middle-income countries (LMICs). However, surgical care for children in LMICs remains poorly understood. Our goal was to define the hospital infrastructure, workforce, and delivery of surgical care for children across Somaliland and provide policy guidance to improve care. METHODS:We used two established hospital assessment tools to assess infrastructure, workforce, and capacity at all hospitals providing surgical care for children across Somaliland. We collected data on all surgical procedures performed in children in Somaliland between August 2016 and July 2017 using operative logbooks. RESULTS:Data were collected from 15 hospitals, including eight government, five for-profit, and two not-for-profit hospitals. Children represented 15.9% of all admitted patients, and pediatric surgical interventions comprised 8.8% of total operations. There were 0.6 surgical providers and 1.2 anesthesia providers per 100,000 population. A total of 1255 surgical procedures were performed in children in all hospitals in Somaliland over 1 year, at a rate of 62.4 surgical procedures annually per 100,000 children. Care was concentrated at private hospitals within urban areas, with a limited number of procedures for many high-burden pediatric surgical conditions. CONCLUSIONS:We found a profound lack of surgical capacity for children in Somaliland. Hospital-level surgical infrastructure, workforce, and care delivery reflects a severely resource-constrained health system. Targeted policy to improved essential surgical care at local, regional, and national levels is essential to improve the health of children in Somaliland.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Concepcion TL,Smith ER,Mohamed M,Dahir S,Ismail EA,Leather AJM,Poenaru D,Rice HE,Global Initiative for Children’s Surgery.doi
10.1007/s00268-019-05079-8subject
Has Abstractpub_date
2019-11-01 00:00:00pages
2934-2944issue
11eissn
0364-2313issn
1432-2323pii
10.1007/s00268-019-05079-8journal_volume
43pub_type
杂志文章abstract：:The moral dilemmas faced by surgeons worldwide who treat patients infected with the human immunodeficiency virus (HIV) can be viewed against the background of experience in sub-Saharan countries, where the community prevalence is in excess of 25% (90% of hospital inpatients). When seeking consent for an HIV test befor...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-003-7101-x
更新日期：2003-08-01 00:00:00
abstract：BACKGROUND:The aim of this study was to compare the influence of either general (GA) or local (LA) anesthesia on the postoperative neurocognitive outcome in patients undergoing carotid endarterectomy (CEA) in a randomized study. Therefore, we performed a subgroup analysis of the multicenter GALA study. METHODS:A total...
journal_title：World journal of surgery
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1007/s00268-009-0047-x
更新日期：2009-07-01 00:00:00
abstract：:A mathematic model is created to determine the economic cost per year of anticipated prolongation of life that would result from a program of abdominal ultrasonographic (US) screening for abdominal aortic aneurysm. The protocol involves US screening at age 60, 67, and 74 years with additional annual follow-up US and e...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF01659032
更新日期：1989-05-01 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: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:Total thyroidectomy is a well-established surgical approach for the management of papillary thyroid cancer (PTC). However, the best surgical approach for papillary microcarcinoma is nowadays still debated. Both total thyroidectomy and simple lobectomy are used. We report the experience of a single University...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3327-7
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Resection of hepatocellular carcinoma (HCC) located in the right liver often requires hepatic mobilization. However, exposure of the HCC may be restricted when using the conventional abdominal approach (AA). In such cases, a thoracoabdominal approach (TA) can provide a good operating field. Although several ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1023-9
更新日期：2011-05-01 00:00:00
abstract：:Unquestionably, progress has been made in the early detection and early treatment of primary liver cancers (PLCs), although most remain unresectable, mainly because the cancer is advanced and coexists with liver cirrhosis, particularly in Oriental patients. Thanks to the progress of regional cancer therapy, a multidis...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00316979
更新日期：1995-01-01 00:00:00
abstract：BACKGROUND:The Acute Surgical Unit (ASU) is a recent change in management of acute general surgical patients in hospitals worldwide. In contrast to traditional management of acute surgical presentations by a rotating on-call system, ASUs are shown to deliver improved efficiency and patient outcomes. This study investig...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2497-z
更新日期：2014-08-01 00:00:00
abstract：:Leiomyomas and leiomyosarcomas are derived from smooth muscle tissues. Smooth muscle cells also surround the blood vessels that supply the alimentary tract. These cells have at times been said to contribute to the formation of smooth muscle tumors in the alimentary canal. With such an abundance of smooth muscle, there...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689910063
更新日期：2000-04-01 00:00:00
abstract：:The hypervascular nature of carcinoid tumors and their metastases allows a more aggressive role by the radiologist in diagnosis and interventional management. Double-contrast gastrointestinal studies still best define the primary neoplasms. Appendiceal tumors, the most frequent site of carcinoids, frequently escape ra...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s002689900023
更新日期：1996-02-01 00:00:00
abstract：:Patients with obstructive jaundice (OJ) that requires surgery often have malnutrition associated with increased perioperative morbidity. This study investigated the factors influencing nutritional derangements in these patients. A series of 46 OJ patients were investigated prospectively (28 malignant tumors, 18 benign...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002680020043
更新日期：2001-04-01 00:00:00
abstract：BACKGROUND:Alternative methods to overcome limitations of electromyogram (EMG) tube applied for intraoperative neuromonitoring (IONM) of recurrent laryngeal nerve (RLN) during thyroidectomy have been introduced. In this study, we evaluated the feasibility of adhesive skin electrodes for IONM of RLN in patients who unde...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-019-05208-3
更新日期：2020-01-01 00:00:00
abstract：:We conducted a prospective case series study to investigate the causes of and factors influencing morbidity and mortality in 102 consecutive patients after elective infrarenal abdominal aneurysm (AAA) surgery between 1992 and 1995. Preoperative factors (demographics, risk factor indexes, electrocardiographic findings,...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s002689900382
更新日期：1998-03-01 00:00:00
abstract：:The serum hyaluronate (HA) level reflects sinusoidal endothelial cell function correlated with liver function. We have reviewed multiple liver function indicators from 37 patients who underwent hepatectomy for various liver diseases. The serum HA level was well correlated with the indocyanine green retention rate at 1...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-004-7389-1
更新日期：2004-10-01 00:00:00
abstract：: ...
journal_title：World journal of surgery
pub_type： 评论,信件
doi：10.1007/s00268-018-4704-9
更新日期：2019-03-01 00:00:00
abstract：:The purpose of this study was to evaluate the surgical outcome of completion thyroidectomy in patients with presumed unilateral well-differentiated thyroid cancer (WDTC). The medical records of all patients having had unilateral thyroid lobectomy for WDTC, who subsequently underwent completion thyroidectomy, were revi...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF02067365
更新日期：1992-07-01 00:00:00
abstract：:Sixty-one patients who were diagnosed with mucosal gastric cancer have been successfully treated with two laparoscopic techniques at our institute from March 1992 to March 1997. One is laparoscopic wedge resection of the stomach using a lesion-lifting method for lesions of the anterior wall, the lesser curvature, and ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00013167
更新日期：1999-02-01 00:00:00
abstract：IMPORTANCE:In resource-limited settings, identification of successful and sustainable task-shifting interventions is important for improving care. OBJECTIVE:To determine whether the training of lay people to take vital signs as trauma clerks is an effective and sustainable method to increase availability of vital sign...
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:Closure of loop ileostomy can be safely performed using sutures or staplers. The aim of the present study was to compare the cost effectiveness of three different techniques. METHODS:A total of 128 consecutive patients who underwent closure of loop ileostomy between January 2002 and December 2008 were analy...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0787-7
更新日期：2010-12-01 00:00:00
abstract：:In the original article, the units indicated on the y-axes of Fig. 3 are incorrectly labelled. The correct label is pg/mL. Following is the corrected Fig. 3. ...
journal_title：World journal of surgery
pub_type： 杂志文章,已发布勘误
doi：10.1007/s00268-020-05520-3
更新日期：2020-07-01 00:00:00
abstract：:Personalized genomic medicine and surgery (PGMS) represents a new approach to health care that customizes patients' medical treatment according to their own genetic information. This new approach is the result of increased knowledge of the human genome and ways this information can be applied by physicians in the medi...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-011-1056-0
更新日期：2011-08-01 00:00:00
abstract：BACKGROUND:Heterotopic pancreas (HP) in the stomach can be difficult to diagnose and there are many treatment options. The aim of this article is to review the contemporary diagnosis of and treatment options for HP in the stomach. METHODS:We undertook a retrospective review of patients with the diagnosis heterotopic p...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-005-0669-6
更新日期：2006-09-01 00:00:00
abstract：INTRODUCTION:Large-bowel obstruction and perforation are still frequently occurring entities for the acute care surgeon. In these cases, Hartmann's procedure is the most commonly used surgical technique. However, recent papers demonstrate that colon resection and primary anastomosis (RPA) in the emergency setting is a ...
journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1007/s00268-012-1513-4
更新日期：2012-05-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to assess the safety and feasibility of performing robot-assisted pediatric surgery using the da Vinci Surgical System in a variety of surgical procedures. METHODS:A retrospective review of 144 robot-assisted pediatric surgical procedures performed in our institution between Ju...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-010-0431-6
更新日期：2010-05-01 00:00:00
abstract：:Radiation therapy has been widely used for palliative management of inoperable metastatic malignant melanoma. For patients with nodal disease, response rates of approximately 70% have been reported. There are limited data concerning the role of adjuvant irradiation following therapeutic lymph node dissection. In this ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF00299160
更新日期：1995-05-01 00:00:00
abstract：OBJECTIVE:The present study was designed to evaluate functional outcome of perineal repair with and without levatorplasty versus transanal repair of rectocele in obstructed defecation. METHODS AND PATIENTS:A total of 48 multiparous women with obstructed defecation caused by a rectocele were randomly allocated to three...
journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-010-0390-y
更新日期：2010-04-01 00:00:00
abstract：:Because of the rarity of adrenocortical carcinoma, survival rates and the prognosis for patients who have undergone operation are not well known. The purpose of the French Association of Endocrine Surgery was to evaluate these factors over an 18-year period. A trend study was associated to assess changes in the clinic...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-001-0047-y
更新日期：2001-07-01 00:00:00
abstract：BACKGROUND:Given surgery's inherent risks, a patient should be able to make the most informed decisions possible in selecting surgical treatment. However, there is little information on what factors patients deem important when choosing a surgeon. We performed a systematic review of the literature focused on how patien...
journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-015-3246-7
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:This prospective, non-randomized, comparative study evaluated morbidity of chemotherapy administration via a totally implantable venous access device (TIVAD) versus peripheral intravenous access (PIVA), and satisfaction in breast cancer patients in a limited-resource setting. METHODS:Consecutive patients re...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-2378-x
更新日期：2014-05-01 00:00:00
