Abstract:
BACKGROUND:Delayed access to surgical care for congenital conditions in low- and middle-income countries is associated with increased risk of death and life-long disabilities, although the actual burden of delayed access to care is unknown. Our goal was to quantify the burden of disease related to delays to surgical care for children with congenital surgical conditions in Somaliland. METHODS:We collected data from medical records on all children (n = 280) receiving surgery for a proxy set of congenital conditions over a 12-month time period across all 15 surgically equipped hospitals in Somaliland. We defined delay to surgical care for each condition as the difference between the ideal and the actual ages at the time of surgery. Disability-adjusted life years (DALYs) attributable to these delays were calculated and compared by the type of condition, travel distance to care, and demographic characteristics. RESULTS:We found long delays in surgical care for these 280 children with congenital conditions, translating to a total of 2970 attributable delayed DALYs, or 8.4 avertable delayed DALYs per child, with the greatest burden among children with neurosurgical and anorectal conditions. Over half of the families seeking surgical care had to travel over 2 h to a surgically equipped hospital in the capital city of Hargeisa. CONCLUSIONS:Children with congenital conditions in Somaliland experience substantial delays to surgical care and travel long distances to obtain care. Estimating the burden of delayed surgical care with avertable delayed DALYs offers a powerful tool for estimating the costs and benefits of interventions to improve the quality of surgical care.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Smith ER,Concepcion TL,Shrime M,Niemeier K,Mohamed M,Dahir S,Ismail EA,Poenaru D,Rice HE,Global Initiative for Children’s Surgery.doi
10.1007/s00268-019-05239-wsubject
Has Abstractpub_date
2020-03-01 00:00:00pages
656-664issue
3eissn
0364-2313issn
1432-2323pii
10.1007/s00268-019-05239-wjournal_volume
44pub_type
杂志文章abstract::A new technique utilizing miniaturized (2 mm) instrumentation to perform laparoscopic cholecystectomy (LC) is introduced. The safety and efficacy of this mini-LC were assessed. Fifty consecutive mini-LCs were performed using one 10-mm port and three 2-mm ports (cumulative port size 16 mm). A 2-mm fiberoptic video-lapa...
journal_title:World journal of surgery
pub_type: 杂志文章
doi:10.1007/pl00013163
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abstract:BACKGROUND:Sometimes, it seems to be difficult to preserve the aberrant hepatic artery (HA) during pancreaticoduodenectomy (PD), with respect to en bloc lymph node dissection, especially in the case of aberrant right hepatic artery (RHA). Therefore, we evaluated the influence of incomplete en bloc lymph node (LN) disse...
journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
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abstract:BACKGROUND:The management of positive ductal margins with carcinoma in situ (R1-CIS) after resection is controversial. The aim of this study was to evaluate the impact of R1-CIS on survival in patients who underwent resection for distal cholangiocarcinoma. METHODS:We enrolled 121 consecutive patients with distal chola...
journal_title:World journal of surgery
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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
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abstract:BACKGROUND:Few clinical studies or randomized clinical trial results have reported the impact of fast-track surgery on human immunity. This study aimed to investigate the clinical and immune impact of fast-track surgery in colorectal cancer patients undergoing elective open surgery. METHODS:A controlled randomized cli...
journal_title:World journal of surgery
pub_type: 杂志文章,随机对照试验
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更新日期:2012-08-01 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 临床试验,杂志文章
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更新日期:1998-06-01 00:00:00
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journal_title:World journal of surgery
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更新日期:2003-09-01 00:00:00
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journal_title:World journal of surgery
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更新日期:2006-09-01 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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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1989-09-01 00:00:00
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journal_title:World journal of surgery
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更新日期:1991-05-01 00:00:00
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更新日期:2018-03-01 00:00:00
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journal_title:World journal of surgery
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更新日期:2006-08-01 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:2019-12-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
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journal_title:World journal of surgery
pub_type: 杂志文章
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journal_title:World journal of surgery
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更新日期:1990-03-01 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:2006-11-01 00:00:00
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journal_title:World journal of surgery
pub_type: 杂志文章
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更新日期:1993-11-01 00:00:00
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journal_title:World journal of surgery
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更新日期:2015-02-01 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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journal_title:World journal of surgery
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更新日期:2016-06-01 00:00:00
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journal_title:World journal of surgery
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journal_title:World journal of surgery
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journal_title:World journal of surgery
pub_type: 杂志文章,多中心研究
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更新日期:2010-05-01 00:00:00