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Williams OM, Faboya OM, Omisanjo OA. Parental Post-operative Telephone Follow-Up After Paediatric Day Case Surgery. World J Surg 2021; 45:3222-3229. [PMID: 34223984 DOI: 10.1007/s00268-021-06228-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND Paediatric day case surgeries (DCSs) are associated with minimal complications therefore the post-operative follow-up visit usually serves to calm anxious parents and is replaceable with a phone call. This study examines the safety and reliability of post-operative telephone assessment by caregivers and its acceptability to them. METHODS Parents of DCS patients over a 9-month period were recruited for telephone follow-up on third post-operative day for wound assessment. The remote reports were compared with the finding during the in-person visit on fourth post-operative day to determine the reliability of parents' observation. The parents' acceptance of telephone follow-up was also studied. RESULTS The parents of 112 children who had groin surgeries (84%), repair of umbilical hernias (4.5%) and excision of soft tissue masses (11.6%) were recruited. The M:F ratio was 10.2:1. The median age at surgery was 64 months (IQR 43.0-96.8) and median waiting time for surgery was 11.5 months (IQR 3.0-28.8). Most caregivers were mothers (83%) and had a minimum of secondary education (86.6%). The telephone and clinic assessments were matched in 98 of 101 assessed patients. Telephone follow-up would have sufficed for 104 (92.9%) patients and correctly identified those who needed clinic visits. Majority of parents found telephone follow-up acceptable in lieu of clinic visit but some preferred to be given a phone number to initiate the call if necessary. CONCLUSION Telephone call is safe, feasible and acceptable for follow-up after paediatric DCS. A guided parents' assessment of the wound is reliable for determining those who need hospital visit.
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Affiliation(s)
- Omolara Modupe Williams
- Department of Surgery, Lagos State University College of Medicine, and Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
| | | | - Olufunmilade Akinfolarin Omisanjo
- Department of Surgery, Lagos State University College of Medicine, and Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
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Kumar R, Choudhury SR, Yadav PS, Kundal R, Gupta A, Hayaran N, Chadha R. An Analysis of Safety and Efficacy of Day-care Surgery in Children in a Tertiary Care Hospital in India. J Indian Assoc Pediatr Surg 2021; 26:148-152. [PMID: 34321785 PMCID: PMC8286014 DOI: 10.4103/jiaps.jiaps_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/18/2020] [Accepted: 05/29/2020] [Indexed: 11/07/2022] Open
Abstract
Background: Advances in surgery and anesthesia have paved the way for the establishment of day-care surgery (DCS). Observations that children achieve better convalescence in the home environment along with significant economic advantages have led to this paradigm shift in clinical practice. Aims and Objectives: This study is aimed to evaluate the feasibility of performing various surgical procedures on day-care basis and assess parental satisfaction with DCS in children. Materials and Methods: In this prospective observational study, all children >3 months of age undergoing various elective surgical procedures as day-care cases in our institution were enrolled. Types of operations, complications, including any unplanned admissions and parental satisfaction, were recorded. Results: Between December 2015 and December 2018, a total of 654 day-care surgeries were performed in our institution by pediatric surgeons. The mean age was 5.5 years with M: F 5.5:1. Thirty different surgical procedures were successfully performed as DCS, the common procedures being inguinal herniotomy (31.5%), and orchidopexy (14.3%). Unplanned admissions were recorded in 2.29% (15/654) patients (scrotal edema-5, postoperative pain-8, and a long recovery from anesthesia-2). No major complications occurred; two minor complications during follow-up were superficial wound infection and drug reaction. Overall parental satisfaction was very high (100%)-preoperative prolonged fasting period and long waiting time in the preoperative room of afternoon shift patients (7.95% and 8.3%) were the reasons for their discontent. Conclusions: DCS in children is safe and effective with high parental satisfaction. It can substantially reduce the waiting list for several surgical procedures in children.
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Affiliation(s)
- Ravikesh Kumar
- Department of Paediatric Surgery, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Subhasis Roy Choudhury
- Department of Paediatric Surgery, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Pratap Singh Yadav
- Department of Paediatric Surgery, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Raksha Kundal
- Department of Anaesthesia, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Amit Gupta
- Department of Paediatric Surgery, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Nitin Hayaran
- Department of Anaesthesia, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
| | - Rajiv Chadha
- Department of Paediatric Surgery, Lady Hardinge Medical College, Kalawati Saran Children's Hospital, New Delhi, India
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Ali Ada MO, Moustapha H, Habou O, Abarchi H. Waiting time for short-stay surgery in a paediatric surgery department. Afr J Paediatr Surg 2021; 18:39-42. [PMID: 33595540 PMCID: PMC8109749 DOI: 10.4103/ajps.ajps_39_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/21/2020] [Accepted: 07/14/2020] [Indexed: 11/04/2022] Open
Abstract
AIM The aim of this study was to assess the waiting time (WT) for a short-stay surgery and determine its possible determinant factors. PATIENTS AND METHODS This was a retrospective study conducted in the Department of Paediatric Surgery at the National Hospital of Lamordé of Niamey, Niger. It included patients aged 0-15 years who benefitted from a short-stay surgery (24-48 h of hospitalisation) during a period of 19 months (1st January 2017 - 31st July 2018). Patient, diagnosis and surgical treatment data were gathered. WT was the time elapsed between the indication of a surgical operation and its realisation. The Kruskal-Wallis test was used with a threshold statistical significance of < 0.05. RESULTS Short-stay surgery constituted 25.4% of all operating activities (n = 271). Inguinal or inguinoscrotal hernia was the most frequent pathology at 31.38% (n = 85). The mean WT was of 116.6 days (range: 4-491 days) and the median was 114 days. WT was greater than or equal to 3 months for 63.9% of the patients (n = 173). Based on pathology, the mean WT varied between 57.5 days (ovarian hernia) and 163.6 days (5.8 months) for epigastric hernia. A significantly longer WT was observed with the presence of a comorbidity (P = 0.0352) but was not associated with patient residence (P = 0.0951). CONCLUSION A long WT for a short-stay surgery should be improved upon by different interventions with respect to the supply and demand of care and the setting of priorities.
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Affiliation(s)
- Mahamoud Omid Ali Ada
- Department of Pediatric Surgery, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Hellé Moustapha
- Department of Pediatric Surgery, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
| | - Oumarou Habou
- Department of Pediatric Surgery, Faculty of Health Sciences, National Hospital of Zinder, University of Zinder, Zinder, Niger
| | - Habibou Abarchi
- Department of Pediatric Surgery, Faculty of Health Sciences, Abdou Moumouni University of Niamey, Niamey, Niger
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Kache SA, Sale D, Ajah JL, Makama JG. Paediatric day-case surgery in a new paediatric surgical unit in Northwestern Nigeria. Afr J Paediatr Surg 2018; 15:97-99. [PMID: 31290472 PMCID: PMC6615002 DOI: 10.4103/ajps.ajps_50_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Day-case surgery is defined as when the surgical day-case patient is admitted for investigation or operation on a planned non-resident basis and who nonetheless requires facilities for recovery. A significant number of our patients were treated as day cases. This study was conducted to audit paediatric day-case surgery practice at our centre, to determine the indications as well as morbidity and mortality from day-case surgeries. PATIENTS AND METHODS This is a prospective study over a period of 14 months. The patients scheduled for surgeries were assessed in the paediatric surgical outpatient clinic and information obtained for each of the patients included age, sex, diagnosis, type of operation, type of anaesthesia and post-operative complications. The data were analysed using SPSS version 15.0 for windows. RESULTS A total of 182 patients were operated during the study period. The age range of patients was 0.5-156 months and the mean age was 46.6 months. There were 152 male patients (83.5%) and 30 female patients (16.5%). Most of the patients had intact prepuce for circumcision (34.1%). Two patients who had herniotomy developed superficial surgical site infections which were managed as outpatients. There were no readmissions or mortality. CONCLUSION Intact prepuce for circumcision as well as hernias and hydroceles is the most common day cases in our centre and is associated with low morbidity and no mortality.
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Affiliation(s)
- Stephen Akau Kache
- Department of Surgery, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria
| | - Danjuma Sale
- Department of Surgery, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria
| | - Jonathan Luka Ajah
- Department of Surgery, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria
| | - Jerry Godfrey Makama
- Department of Surgery, Barau Dikko Teaching Hospital, Kaduna State University, Kaduna, Nigeria
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de Luca U, Mangia G, Tesoro S, Martino A, Sammartino M, Calisti A. Guidelines on pediatric day surgery of the Italian Societies of Pediatric Surgery (SICP) and Pediatric Anesthesiology (SARNePI). Ital J Pediatr 2018. [PMID: 29530049 PMCID: PMC5848546 DOI: 10.1186/s13052-018-0473-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The Italian Society of Pediatric Surgery (SICP) together with The Italian Society of Pediatric Anesthesia (SARNePI) through a systematic analysis of the scientific literature, followed by a consensus conference held in Perugia on 2015, have produced some evidence based guidelines on the feasibility of day surgery in relation to different pediatric surgical procedures. The main aspects of the pre-operative assessment, appropriacy of operations and discharge are reported.
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Affiliation(s)
- Ugo de Luca
- Day Surgery Unit, Santobono-Pausilipon Pediatric Hospital, Napoli, Italy.
| | - Giovanni Mangia
- Department of Anesthesiology, San Camillo Forlanini Hospital, Roma, Italy
| | - Simonetta Tesoro
- Department of Anesthesiology, Perugia University, Perugia, Italy
| | | | - Maria Sammartino
- Department of Anesthesiology, Policlinico A. Gemelli, Roma, Italy
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Burgos CM, Bolkan HA, Bash-Taqi D, Hagander L, von Schreeb J. The Met Needs for Pediatric Surgical Conditions in Sierra Leone: Estimating the Gap. World J Surg 2018; 42:652-665. [PMID: 28932917 PMCID: PMC5801385 DOI: 10.1007/s00268-017-4244-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND In low- and middle-income countries, there is a gap between the need for surgery and its equitable provision, and a lack of proxy indicators to estimate this gap. Sierra Leone is a West African country with close to three million children. It is unknown to what extent the surgical needs of these children are met. AIM To describe a nationwide provision of pediatric surgical procedures and to assess pediatric hernia repair as a proxy indicator for the shortage of surgical care in the pediatric population in Sierra Leone. METHODS We analyzed results from a nationwide facility survey in Sierra Leone that collected data on surgical procedures from operation and anesthesia logbooks in all facilities performing surgery. We included data on all patients under the age of 16 years undergoing surgery. Primary outcomes were rate and volume of surgical procedures. We calculated the expected number of inguinal hernia in children and estimated the unmet need for hernia repair. RESULTS In 2012, a total of 2381 pediatric surgical procedures were performed in Sierra Leone. The rate of pediatric surgical procedures was 84 per 100,000 children 0-15 years of age. The most common pediatric surgical procedure was hernia repair (18%), corresponding to a rate of 16 per 100,000 children 0-15 years of age. The estimated unmet need for inguinal hernia repair was 88%. CONCLUSIONS The rate of pediatric surgery in Sierra Leone was very low, and inguinal hernia was the single most common procedure noted among children in Sierra Leone.
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Affiliation(s)
| | - Håkon Angell Bolkan
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Lars Hagander
- Surgery and Public Health, Pediatric Surgery, Department of Clinical Sciences in Lund, Skåne University Hospital, Lund University, Lund, Sweden
| | - Johan von Schreeb
- Global Health-Health System and Policy Department of Public Health Sciences, Centre for Research on Health Care in Disasters, Stockholm, Sweden
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Sam CJ, Arunachalam PA, Manivasagan S, Surya T. Parental Satisfaction with Pediatric Day-Care Surgery and its Determinants in a Tertiary Care Hospital. J Indian Assoc Pediatr Surg 2017; 22:226-231. [PMID: 28974875 PMCID: PMC5615897 DOI: 10.4103/jiaps.jiaps_212_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: The objective is to assess the level of parental satisfaction of pediatric day-care surgery and its different determinants. Materials and Methods: This is a descriptive study performed in a tertiary care hospital in India among parents of pediatric day-care surgery patients from June 2013 to March 2015. The core questionnaire for the assessment of patient satisfaction for general day care (COPS-D) was used. Variables related to surgery, overall satisfaction, one open-ended question, and socio-demographic data were also collected. Calculated sample size was 121. Results: The mean and standard deviation of parental satisfaction were estimated in eight domains of day care (COPS-D) using Likert scale 1–5. Preadmission visit had a mean of 4.63 (0.52), day of surgery 4.65 (0.58), operating room 4.76 (0.51), nursing care 4.46 (0.79), medical care 4.89 (0.48), information 4.51 (0.68), autonomy 4.64 (0.56), and discharge 4.50 (0.72). In elder children, there was less satisfaction on the information and discharge domains. Overall satisfaction was good in 88% of patients and was less than satisfactory when they had significant pain. Conclusion: Perception of quality of pediatric day-care surgery was assessed with a questionnaire and was found to be good. Variables related to surgery such as pain may be included in the questionnaire for assessing satisfaction in the day-care surgery.
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Affiliation(s)
- Cenita James Sam
- Department of Pediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Pavai A Arunachalam
- Department of Pediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Sivamani Manivasagan
- Department of Community Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - T Surya
- Department of Pediatric Surgery, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
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Abstract
The concept of surgical waiting time initiative (SWAT) was introduced in developed countries to reduce elective surgery waiting lists and increase efficiency of care. It was supplemented by increasing popularity of day surgery, which shortens elective waiting lists and minimises cancellations. It is established in Western countries, but not in developing countries like Nigeria where it is still evolving. A search was carried out in Pub Med, Google, African journals online (AJOL), Athens and Ovid for relevant publications on elective surgery waiting list in Nigeria, published in English language. Words include waiting/wait time, waiting time initiative, time to surgery, waiting for operations, waiting for intervention, waiting for procedures and time before surgery in Nigeria. A total of 37 articles published from Nigeria in relation to various waiting times were found from the search and fulfilled the inclusion criteria. Among them, 11 publications (29.7%) were related to emergency surgery waiting times, 10 (27%) were related to clinic waiting times, 9 (24.3%) were related to day case surgery, 2 (5.5%) were related to investigation waiting times and only 5 (13.5%) articles were specifically published on elective surgery waiting times. A total of 9 articles (24.5%) were published from obstetrics and gynaecology (OG), 7 (19%) from general surgery, 5 (13.5%) from public health, 3 (8%) from orthopaedics, 3 (8%) from general practice (GP), 3 (8%) from paediatrics/paediatric surgery, 2 (5.5%) from ophthalmology, 1 (2.7%) from ear, nose and throat (ENT), 1 (2.7%) from plastic surgery, 1 (2.7%) from urology and only 1 (2.7%) article was published from dental/maxillofacial surgery. Waiting times mean different things to different health practitioners in Nigeria. There were only 5/37 articles (13.5%) specifically related to elective surgery waiting times in Nigerian hospitals, which show that the concept of the SWAT is still evolving in Nigeria. Of the 37, 11 (24.5%) publications were from obstetrics and gynaecology (O & G) alone, but these were mostly related to emergency antenatal care rather than surgery. Therefore, more research and initiative needs to be undertaken from all the surgical sub-specialties in order to disseminate this concept of SWAT towards early diagnosis and treatment of elective life-threatening conditions, as well as effective patient care. Adopting this concept will help healthcare managers and policy makers to stream line and ring face resources to cater for non-urgent or semi-urgent cases presenting to our hospitals in Nigeria.
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Affiliation(s)
- Imran Haruna Abdulkareem
- Department of Trauma and Orthopaedic Surgery, Leeds University Teaching Hospitals, Leeds, West Yorkshire, United Kingdom
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