Abstract：
BACKGROUND:The world's poorest 2 billion people, benefit from no more than about 3.5% of the world's operative procedures. The burden of surgical disease is greatest in Africa, where operations could save many lives. Previous facility-based studies have described operative procedure caseloads, but prospective studies investigating interventions, indications and perioperative mortality rates (POMR), are rare. METHODS:A prospective, questionnaire-based collection of data on all major and minor operative procedures was undertaken at 2 hospitals in rural Uganda covering 4 and 3 months in 2011, respectively. Data included patient characteristics, indications for the interventions performed, and outcome after surgery. RESULTS:We recorded 2,790 operative procedures on 2,701 patients. The rate of major operative procedures per 100,000 population per year was 225. Patients undergoing major operative procedures (n = 1,051) were mostly women (n = 923; 88%) because most interventions were performed owing to pregnancy-related complications (n = 747; 67%) or gynecologic conditions (n = 114; 10%). General operative interventions registered included herniorrhaphy (n = 103; 9%), exploratory laparotomy (n = 60; 5%), and appendectomy (n = 31; 3%). The POMR for major operative procedures was 1% (n = 14) and was greatest after exploratory laparotomy (13%; n = 8) and caesarean delivery (1%; n = 4). Most deaths (n = 16) were a result of sepsis (n = 10-11) or hemorrhage (n = 3-5). CONCLUSION:The volume of surgery was low relative to the size of the catchment population. The POMR was high. Exploratory laparotomy and caesarean section were identified as high-risk procedures. Increased availability of blood, improved perioperative monitoring, and early intervention could be part of a solution to reduce the POMR.
journal_name
Surgeryjournal_title
Surgeryauthors
Löfgren J,Kadobera D,Forsberg BC,Mulowooza J,Wladis A,Nordin Pdoi
10.1016/j.surg.2015.03.022subject
Has Abstractpub_date
2015-07-01 00:00:00pages
7-16issue
1eissn
0039-6060issn
1532-7361pii
S0039-6060(15)00215-9journal_volume
158pub_type
杂志文章相关文献
SURGERY文献大全abstract：BACKGROUND:An altered immune microenvironment may contribute to papillary thyroid cancer development, as immune infiltrates are identified postoperatively in many papillary thyroid cancer cases with or without diagnosed thyroiditis. Oxygen radicals, endogenous or inflammation-induced, can generate DNA damage, which cau...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2019.02.024
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Although hepatic resection is the most reliable treatment for hepatocellular carcinoma, impaired liver function because of cirrhosis or chronic hepatitis contributes to relatively high rates of postoperative complications. We have reviewed a series of hepatectomies at our institution and investigated risk fa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：BACKGROUND:Interaction of the CD11/CD18 complex on polymorphonuclear neutrophils (PMNs) and intercellular adhesion molecule (ICAM)-1 on endothelium is a critical event in PMN-mediated tissue injury. In addition, increased expression of ICAM-1 on type I pneumocytes has been identified in a variety of pulmonary disorders...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(05)80320-4
更新日期：1995-08-01 00:00:00
abstract：INTRODUCTION:Posthepatectomy liver failure (PHLF) is a severe complication after hepatectomy for colorectal liver metastases. This study evaluated its actual incidence and its effects on short- and long-term overall survival (OS) in a specialized center. MATERIALS AND METHODS:Between 2006 and 2008, 193 patients who un...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2013.05.039
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:Postoperative hepatic decompensation is a serious complication of liver resection in patients undergoing hepatectomy for hepatocellular carcinoma. Liver fibrosis and clinical significant portal hypertension are well-known risk factors for hepatic decompensation. Liver stiffness measurement is a noninvasive m...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2017.06.006
更新日期：2017-10-01 00:00:00
abstract：BACKGROUND:Hypoparathyroidism is the most frequent permanent complication of thyroid surgery. Our hypothesis is that human precursor cells in culture can be differentiated into parathyroid cells and used to reconstitute function. Human embryonic stem cells (hESCs) are a stable model to study differentiation into parath...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2010.09.021
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:The purpose of the present study is to compare postoperative pain and functional outcomes in patients undergoing inguinal herniorrhaphy who receive a continuous wound infusion of bupivacaine to those who receive an infusion of saline. METHODS:A prospective, randomized, blinded, placebo-controlled trial was ...
journal_title：Surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.surg.2004.06.016
更新日期：2004-10-01 00:00:00
abstract：:This prospective study evaluates the use of intraoperative flexible choledochoscopy in the detection and removal of additional stones after conventional bile duct exploration. The biliary system of 109 patients was examined with an Olympus CHF-B4 choledochoscope after conventional methods of exploration. Sixty-five pa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1987-05-01 00:00:00
abstract：BACKGROUND:Wound complications after lower extremity arterial reconstruction can range from a minor lymphatic leak that causes minimal disability to a severe infection that jeopardizes the limb and life of the affected patient. This study was designed to define more clearly the incidence, severity, and the cost of thes...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(96)80135-8
更新日期：1996-04-01 00:00:00
abstract：:Nelson's syndrome--progressive cutaneous hyperpigmentation with x-ray film evidence of an expanding pituitary tumor--is now a well-recognized sequela of bilateral adrenalectomy for Cushing's disease. It is estimated to occur in 8% to 38% of adults. Because Cushing's disease is rare in children, a higher incidence of N...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1984-12-01 00:00:00
abstract：BACKGROUND:Neoadjuvant chemotherapy (NACT) has been frequently used for locally advanced esophageal squamous cell cancer (ESCC). It is therefore important to establish criteria for evaluating the response to NACT based on survival analysis. METHODS:This study analyzed 100 patients with ESCC (cT1, 2/3/4:25/57/18, cN0/1...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2010.02.016
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Resection for hepatocellular carcinoma in patients with cirrhosis and impaired liver function is usually unjustified because of higher surgical risks and poorer long-term prognosis. METHODS:A retrospective comparison of the background and resectional results of patients with cirrhosis and hepatocellular car...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(96)80238-8
更新日期：1996-07-01 00:00:00
abstract：BACKGROUND:Patients with primary mediastinal lymphomas frequently present with a residual mass after completion of first-line therapy. Although a positron emission tomography scan is usually recommended, it fails to distinguish between persistent lymphoma and inflammation. Although percutaneous biopsy may have a high d...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.05.039
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND:Adaptation after massive smallbowel resection (SBR) is associated with increased cell turnover, increased rates of enterocyte proliferation, and apoptosis. Epidermal growth factor receptor (EGFR) inhibition attenuates adaptation and increases apoptosis. Intestinal levels of bax appear to correlate with EGFR ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2004.04.004
更新日期：2004-08-01 00:00:00
abstract：:The purpose of this project was to evaluate the acute and chronic effects of sclerotherapy on esophageal motility and function. We studied motility in eight patients before and after injection sclerotherapy of esophageal varices. We injected the varices with 5% sodium morrhuate twice during the first week and then at ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：BACKGROUND:Apoptosis-suppressing gene, bcl-2, and apoptosis-inducing gene, bax, are expressed in various tumors. Human telomerase reverse transcriptase (hTERT) expression is increased in many cancers. The purpose of this investigation was to determine whether bcl-2 or bax gene expression differs between benign and mali...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1067/msy.2002.128616
更新日期：2002-12-01 00:00:00
abstract：BACKGROUND:We wished to determine the role and significance of preoperative chemotherapy and radiotherapy in management of operable cancer of the esophagus. METHODS:Twenty-two patients with clinical stage I-II cancer of the esophagus were entered in a prospective study of preoperative chemotherapy (5-fluorouracil/cisp...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1993-07-01 00:00:00
abstract：:The influence of cimetidine on blood flow to the gastric corpus and antrum of the dog was studied using the double isotope microsphere distribution technique. This H2 receptor antagonist caused no changes in blood flow to any portion of the stomach nor did it alter systemic circulatory parameters. The therapeutic effe...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1978-08-01 00:00:00
abstract：:Accuracy and clinical applications of noninvasive imaging of the extracranial carotid arteries were compared using pulsed Doppler and real-time B-mode ultrasonography. During the period December, 1977, to February, 1979, 530 ultrasonograms (265 patients) were performed. Angiographic correlations were available in 90 p...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1980-03-01 00:00:00
abstract：BACKGROUND:The prognostic significance of the leukocyte subsets in peripheral blood has not yet been investigated in hepatocellular carcinoma patients. We sought to clarify the prognostic value of preoperative peripheral blood leukocyte subset counts, especially the absolute monocyte count, in HCC patients who have und...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2005.10.009
更新日期：2006-06-01 00:00:00
abstract：:In patients with primary hyperparathyroidism, measurements were made of basal and stimulated levels of intact parathyroid hormone (PTH). The basal PTH values were elevated in all but six of 89 patients and provided clear separation towards normal individuals (n = 75) and patients with hypercalcemia of other origin (n ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1991-07-01 00:00:00
abstract：:The incidence and management of complications of injection sclerotherapy are reviewed in 304 consecutive patients with esophageal varices followed up prospectively for a 10-year period. The 304 patients were injected on 1336 occasions. Three hundred eleven local esophageal complications occurred in 140 patients (compl...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1989-02-01 00:00:00
abstract：BACKGROUND:Interleukin 12 (IL-12) p70 is a heterodimeric protein (p35, p40 subunits) that promotes T-helper TH1-type cytokine response. In critically ill patients, after severe trauma or sepsis, IL-12 production is markedly impaired. We tested the hypothesis that deficiency of the transcription factor c-fos will increa...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1999-08-01 00:00:00
abstract：:To further define the clinicopathologic features and determinants of survival, we reviewed the cases of 110 patients with primary hepatic malignancy managed surgically between 1975 and 1986. Presenting signs of symptoms were pain (57%), fatigue (48%), abdominal mass (40%), and weight loss (33%). Twenty-six percent of ...
journal_title：Surgery
pub_type： 杂志文章
doi：
更新日期：1989-10-01 00:00:00
abstract：BACKGROUND:Secondary peritonitis continues to carry a high mortality rate despite the aggressive use of imaging, drainage, and antibiotics. Although host factors and microbial burden contribute to the outcome of peritonitis, we propose a role for bacterial virulence as a determinant of outcome from peritonitis. Bacteri...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2012.06.022
更新日期：2013-01-01 00:00:00
abstract：BACKGROUND:Postoperative cervical hemorrhage is a rare but life-threatening complication that can cause severe morbidity. Different mechanisms leading to asphyxia have been described based only on clinical observation. METHODS:We performed a series of in vivo animal studies simulating post-thyroidectomy hemorrhage and...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2018.05.022
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Alternative methods for abdominal wall closure may be necessary after emergency laparotomy. The purpose of this study was to determine the morbidity and outcome of emergency fascial closure with polypropylene mesh. METHODS:A retrospective review was performed of all patients undergoing emergency fascial clo...
journal_title：Surgery
pub_type： 杂志文章,评审
doi：10.1016/s0039-6060(05)80043-1
更新日期：1995-10-01 00:00:00
abstract：BACKGROUND:Rib fractures are common and associated with significant pulmonary morbidity. We hypothesized that epidural analgesia would provide superior pain relief, and reduce the risk of subsequent pneumonia. METHODS:A prospective, randomized trial of epidural analgesia versus IV opioids for the management of chest w...
journal_title：Surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/j.surg.2004.05.019
更新日期：2004-08-01 00:00:00
abstract：BACKGROUND:We have previously reported that vascular inducible nitric oxide synthase (iNOS) gene transfer inhibits injury-induced intimal hyperplasia in vitro and in vivo. One mechanism by which NO may prevent intimal hyperplasia is by preserving the endothelium or promoting its regeneration. To study this possibility ...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/s0039-6060(97)90016-7
更新日期：1997-08-01 00:00:00
abstract：BACKGROUND:The prevalence of insomnia in patients with symptomatic secondary hyperparathyroidism and the improvements of sleep disturbances after parathyroidectomy have not been previously reported. METHODS:Thirty-one patients who had undergone successful total parathyroidectomy and autotransplantation for symptomatic...
journal_title：Surgery
pub_type： 杂志文章
doi：10.1016/j.surg.2004.12.010
更新日期：2005-04-01 00:00:00
