Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review
Laparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes...
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doaj-28ff32c2aff440369ab681d4cd546e2e2021-06-01T01:27:31ZengMDPI AGInternational Journal of Environmental Research and Public Health1661-78271660-46012021-05-01185796579610.3390/ijerph18115796Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature ReviewDamiano Pizzol0Mike Trott1Igor Grabovac2Mario Antunes3Anna Claudia Colangelo4Simona Ippoliti5Cristian Petre Ilie6Anne Carrie7Nicola Veronese8Lee Smith9Italian Agency for Development Cooperation, Khartoum 11111, SudanThe Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UKDepartment of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna 1010, AustriaDepartment of Surgery, Central Hospital of Beira, Beira 13016, MozambiqueDepartment of Surgery and Organ Transplantation, University of Padua, 35125 Padua, ItalyDepartment of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UKDepartment of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UKDepartment of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UKGeriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90121 Palermo, ItalyThe Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UKLaparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes of this procedure in resource-limited settings. We retrospectively reviewed all cases of laparoscopy recorded from January 2007 to March 2017 at the Department of Surgery of Beira to assess the related outcomes. Moreover, we performed a systematic review of the laparoscopic practices and outcomes in low-income countries. Data from the Department of Surgery of Beira identified 363 laparoscopic procedures, mainly relating to gynecological diseases, cholelithiasis, and appendicectomy with only a 1.6% complication rate (6 cases) and a 1.9% conversion rate (7 cases) to open surgery. The systematic review showed a pooled risk of overall complications significantly lower in laparoscopic vs. open appendicectomy (OR = 0.43; 95% CI 0.19–0.97; I<sup>2</sup> = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43–0.65; I<sup>2</sup> = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI −0.00; 1.15; I<sup>2</sup> = 96.52), while the pooled SMD in hospitalization days was −1.35 (95% CI −1.87; −0.82; I<sup>2</sup> = 96.41). Laparoscopy is an expensive procedure to adopt as it requires new equipment and specialized trained health workers. However, it could reduce post-operative costs and complications, especially in terms of infections. It is crucial to increase its accessibility, acceptability, and quality particularly in LMICs, especially during this COVID-19 era when the reduction of patient hospitalization is essential.https://www.mdpi.com/1660-4601/18/11/5796laparoscopylow-income countriesminimal invasive surgery |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Damiano Pizzol Mike Trott Igor Grabovac Mario Antunes Anna Claudia Colangelo Simona Ippoliti Cristian Petre Ilie Anne Carrie Nicola Veronese Lee Smith |
spellingShingle |
Damiano Pizzol Mike Trott Igor Grabovac Mario Antunes Anna Claudia Colangelo Simona Ippoliti Cristian Petre Ilie Anne Carrie Nicola Veronese Lee Smith Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review International Journal of Environmental Research and Public Health laparoscopy low-income countries minimal invasive surgery |
author_facet |
Damiano Pizzol Mike Trott Igor Grabovac Mario Antunes Anna Claudia Colangelo Simona Ippoliti Cristian Petre Ilie Anne Carrie Nicola Veronese Lee Smith |
author_sort |
Damiano Pizzol |
title |
Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review |
title_short |
Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review |
title_full |
Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review |
title_fullStr |
Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review |
title_full_unstemmed |
Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review |
title_sort |
laparoscopy in low-income countries: 10-year experience and systematic literature review |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1661-7827 1660-4601 |
publishDate |
2021-05-01 |
description |
Laparoscopy is a procedure that ultimately reduces hospital stay time and speeds up post-operative recovery. It is mainly performed in high-income countries but its implementation in many low- and middle-income countries (LMICs) is increasing. However, no aggregate data exist regarding the outcomes of this procedure in resource-limited settings. We retrospectively reviewed all cases of laparoscopy recorded from January 2007 to March 2017 at the Department of Surgery of Beira to assess the related outcomes. Moreover, we performed a systematic review of the laparoscopic practices and outcomes in low-income countries. Data from the Department of Surgery of Beira identified 363 laparoscopic procedures, mainly relating to gynecological diseases, cholelithiasis, and appendicectomy with only a 1.6% complication rate (6 cases) and a 1.9% conversion rate (7 cases) to open surgery. The systematic review showed a pooled risk of overall complications significantly lower in laparoscopic vs. open appendicectomy (OR = 0.43; 95% CI 0.19–0.97; I<sup>2</sup> = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43–0.65; I<sup>2</sup> = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI −0.00; 1.15; I<sup>2</sup> = 96.52), while the pooled SMD in hospitalization days was −1.35 (95% CI −1.87; −0.82; I<sup>2</sup> = 96.41). Laparoscopy is an expensive procedure to adopt as it requires new equipment and specialized trained health workers. However, it could reduce post-operative costs and complications, especially in terms of infections. It is crucial to increase its accessibility, acceptability, and quality particularly in LMICs, especially during this COVID-19 era when the reduction of patient hospitalization is essential. |
topic |
laparoscopy low-income countries minimal invasive surgery |
url |
https://www.mdpi.com/1660-4601/18/11/5796 |
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