Analyzing complications and implementing solutions in a pediatric inguinal hernia cooperation program in Equatorial Guinea: a prospective cohort study | ||||
| Annals of Pediatric Surgery | ||||
| Volume 19, Issue 1, January 2023 PDF (1.11 MB) | ||||
| DOI: 10.1186/s43159-022-00237-5 | ||||
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| 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
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| Abstract | ||||
| 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 ( = 94), and 5.8% ( < 0.001) and 0.5% ( = 0.012) in the control group, respectively. Group A had 20.2% loss-to-follow-up. In group B ( = 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% ( = 0.350) and 1.6% ( = 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. | ||||
| Keywords | ||||
| Short-term medical mission; Pediatric inguinal hernia; Pediatric surgery cooperation program; Complication rates; Surgical Site Infection | ||||
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