Jaime Rodríguez de Alarcón García, Amalia Úbeda Pascual, María Fanjul Gómez, Pablo Morató Robert, Rocío Espinosa Góngora, Ernesto Martínez García, Carlos Román Guerrero, Santiago Jaime Abaga Abaga, Carmen Soto Beauregard
{"title":"分析赤道几内亚儿童腹股沟疝合作项目的并发症和实施解决方案:一项前瞻性队列研究。","authors":"Jaime Rodríguez de Alarcón García, Amalia Úbeda Pascual, María Fanjul Gómez, Pablo Morató Robert, Rocío Espinosa Góngora, Ernesto Martínez García, Carlos Román Guerrero, Santiago Jaime Abaga Abaga, Carmen Soto Beauregard","doi":"10.1186/s43159-022-00237-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity.</p><p><strong>Methods: </strong>In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017-2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged < 18 years treated in referral campaigns were included. Complications occurring up to 6 months post-operatively were evaluated. Two stages were defined: Stage 1, wherein, complication rate in group A was compared to that in a control group from a tertiary hospital in Spain (with a case-control ratio of 1:2, paired according to age, sex and diagnosis); stage 2, wherein, complication rates between groups A and B were compared. Group B received a single dose of prophylactic amoxicillin-clavulanic acid. Follow-up capacity was assessed through follow-up appointments.</p><p><strong>Results: </strong>In stage 1, complication and surgical site infection (SSI) rates were 21.3% and 7.4% in group A (<i>n</i> = 94), and 5.8% (<i>p</i> < 0.001) and 0.5% (<i>p</i> = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B (<i>n</i> = 62), 6-month postoperative follow-up could not be assessed owing to restrictions due to the COVID-19 pandemic, so only early complications were considered in stage 2, were complication and surgical site infection rates were 18.1% and 7.4% in group A and 11.3% (<i>p</i> = 0.350) and 1.6% (<i>p</i> = 0.150) in group B.</p><p><strong>Conclusion: </strong>Our results showed higher than expected complication rates. Pre-operative prophylactic antibiotic could not show to reduce SSI. Further studies are needed to reduce complication rates in these campaigns. Patient loss-to-follow-up ratio warrants considering new strategies.</p>","PeriodicalId":43372,"journal":{"name":"Annals of Pediatric Surgery","volume":"19 1","pages":"5"},"PeriodicalIF":0.4000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830599/pdf/","citationCount":"0","resultStr":"{\"title\":\"Analyzing complications and implementing solutions in a pediatric inguinal hernia cooperation program in Equatorial Guinea: a prospective cohort study.\",\"authors\":\"Jaime Rodríguez de Alarcón García, Amalia Úbeda Pascual, María Fanjul Gómez, Pablo Morató Robert, Rocío Espinosa Góngora, Ernesto Martínez García, Carlos Román Guerrero, Santiago Jaime Abaga Abaga, Carmen Soto Beauregard\",\"doi\":\"10.1186/s43159-022-00237-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity.</p><p><strong>Methods: </strong>In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017-2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged < 18 years treated in referral campaigns were included. Complications occurring up to 6 months post-operatively were evaluated. Two stages were defined: Stage 1, wherein, complication rate in group A was compared to that in a control group from a tertiary hospital in Spain (with a case-control ratio of 1:2, paired according to age, sex and diagnosis); stage 2, wherein, complication rates between groups A and B were compared. Group B received a single dose of prophylactic amoxicillin-clavulanic acid. Follow-up capacity was assessed through follow-up appointments.</p><p><strong>Results: </strong>In stage 1, complication and surgical site infection (SSI) rates were 21.3% and 7.4% in group A (<i>n</i> = 94), and 5.8% (<i>p</i> < 0.001) and 0.5% (<i>p</i> = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B (<i>n</i> = 62), 6-month postoperative follow-up could not be assessed owing to restrictions due to the COVID-19 pandemic, so only early complications were considered in stage 2, were complication and surgical site infection rates were 18.1% and 7.4% in group A and 11.3% (<i>p</i> = 0.350) and 1.6% (<i>p</i> = 0.150) in group B.</p><p><strong>Conclusion: </strong>Our results showed higher than expected complication rates. Pre-operative prophylactic antibiotic could not show to reduce SSI. Further studies are needed to reduce complication rates in these campaigns. Patient loss-to-follow-up ratio warrants considering new strategies.</p>\",\"PeriodicalId\":43372,\"journal\":{\"name\":\"Annals of Pediatric Surgery\",\"volume\":\"19 1\",\"pages\":\"5\"},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2023-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9830599/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Pediatric Surgery\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s43159-022-00237-5\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Pediatric Surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s43159-022-00237-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PEDIATRICS","Score":null,"Total":0}
Analyzing complications and implementing solutions in a pediatric inguinal hernia cooperation program in Equatorial Guinea: a prospective cohort study.
Background: Few studies have evaluated the efficacy of short-term medical missions. This study was aimed to evaluate complication rates and determine the effects of protocol changes in a pediatric inguinal hernia campaign in Equatorial Guinea and analyze post-operative follow-up capacity.
Methods: In this prospective observational cohort study, we evaluated two patient cohorts (group A, 2017-2018; group B, 2019) treated during campaigns in Equatorial Guinea for congenital inguinal pathology (hernia, hydrocele, and cryptorchidism). Patients aged < 18 years treated in referral campaigns were included. Complications occurring up to 6 months post-operatively were evaluated. Two stages were defined: Stage 1, wherein, complication rate in group A was compared to that in a control group from a tertiary hospital in Spain (with a case-control ratio of 1:2, paired according to age, sex and diagnosis); stage 2, wherein, complication rates between groups A and B were compared. Group B received a single dose of prophylactic amoxicillin-clavulanic acid. Follow-up capacity was assessed through follow-up appointments.
Results: In stage 1, complication and surgical site infection (SSI) rates were 21.3% and 7.4% in group A (n = 94), and 5.8% (p < 0.001) and 0.5% (p = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B (n = 62), 6-month postoperative follow-up could not be assessed owing to restrictions due to the COVID-19 pandemic, so only early complications were considered in stage 2, were complication and surgical site infection rates were 18.1% and 7.4% in group A and 11.3% (p = 0.350) and 1.6% (p = 0.150) in group B.
Conclusion: Our results showed higher than expected complication rates. Pre-operative prophylactic antibiotic could not show to reduce SSI. Further studies are needed to reduce complication rates in these campaigns. Patient loss-to-follow-up ratio warrants considering new strategies.
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