Analyzing complications and implementing solutions in a pediatric inguinal hernia cooperation program in Equatorial Guinea: a prospective cohort study

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...

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Bibliographic Details
Published in:Annals of pediatric surgery Vol. 19; no. 1; p. 5
Main Authors: Rodríguez de Alarcón García, Jaime, Úbeda Pascual, Amalia, Fanjul Gómez, María, Morató Robert, Pablo, Espinosa Góngora, Rocío, Martínez García, Ernesto, Román Guerrero, Carlos, Abaga Abaga, Santiago Jaime, Soto Beauregard, Carmen
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2023
Springer Nature B.V
SpringerOpen
Subjects:
Age groups
Anemia
Antibiotics
Cohort analysis
Complication rates
Cooperation
Cryptorchidism
Hematoma
Hemoglobin
Hepatitis B
Hepatitis C
Hernias
HIV
Human immunodeficiency virus
Immune system
Infectious diseases
Malaria
Malnutrition
Medicine
Medicine & Public Health
Nutritional status
Obesity
Original Research
Patients
Pediatric inguinal hernia
Pediatric surgery cooperation program
Pediatrics
Penicillin
Short-term medical mission
Surgery
Surgical site infection
Surgical site infections
Equatorial Guinea
Surgical site infection
Complication rates
Pediatric surgery cooperation program
Short-term medical mission
Pediatric inguinal hernia
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Summary: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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ISSN:2090-5394
1687-4137
2090-5394
DOI:10.1186/s43159-022-00237-5