Surgical disease

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Tracking perioperative mortality and maternal mortality: challenges and opportunities

Access to surgery remains inequitable worldwide, with 5 billion people lacking safe and affordable surgical and anaesthesia care when needed.1 The Lancet Commission on Global Surgery was convened in 2013 to assess the state of surgery around the world, provide recommendations for improving access, and propose indicators for assessing national surgical systems. A key safety indicator is the perioperative mortality rate (POMR). This is defined by the Commission as the number of all-cause deaths before discharge in patients who have undergone a procedure in an operating theatre, divided by the total number of procedures, and presented as a percentage.

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Closing the data gaps for surgical care delivery in LMICs

In their study in The Lancet Global Health, Tarsicio Uribe-Leitz and colleagues1 find great discrepancies in surgical outcomes across the regions of the world.1 The authors examined three procedures that are fairly standardised in their operative indications and techniques (caesarean delivery, appendectomy, and groin hernia repair), and thus for which reporting should be nearly uniform. By undertaking a robust systematic review, Uribe-Leitz and colleagues have shown that quality surgical outcome data are a relatively void zone in low-income and middle-income countries (LMICs).

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Transforming research results into useful tools for global health: BOOST

We reported the results of the PRECOG study1 in the inaugural issue of The Lancet Global Health (July, 2013). Although visual outcomes of cataract surgery have usually been assessed weeks or months after surgery, this study of 4000 patients at 40 hospitals in low-income and middle-income countries (LMICs), where few patients return after operations, demonstrated that assessment of vision the day after surgery could reliably measure operative quality. We felt the readers of The Lancet Global Health might be interested to hear about the next chapter of this work.

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Task-sharing or public finance for the expansion of surgical access in rural Ethiopia: an…

Despite a high burden of surgical disease, access to surgical services in low- and middle-income countries is often limited.


An innovative safe anesthesia and analgesia package for emergency pediatric procedures and…

Adequate pain control through sedation and anesthesia for emergency procedures is a crucial aspect of pediatric emergency care.


Blantyre-Oslo Neurosurgery Program

(no abstract available)(Published: 3 June 2016)Citation: Glob Health Action 2016, 9: 32016 – http://dx.doi.org/10.3402/gha.v9.32016


Better Access To Surgeons, High Quality Obstetric Care Critical To Preventing, Treating Fistula

The Guardian: Why do a million women still suffer the treatable condition of fistula? Kate Grant, CEO of the Fistula Foundation “…The most crucial variable in the outcomes for women is the competency of the surgeon developed over years of experience. Yet the biggest challenge to treating more women [with fistula] goes beyond money, it…More


Topical fluorouracil after surgery for ocular surface squamous neoplasia in Kenya: a…

Topical fluorouracil after surgery substantially reduced recurrence of OSSN, was well-tolerated, and its use recommended.


Prioritizing Surgical Care on National Health Agendas: A Qualitative Case Study of Papua New…

by Anna J. Dare, Katherine C. Lee, Josh Bleicher, Alex E. Elobu, Thaim B.


Hospital Surgical Volumes and Mortality after Coronary Artery Bypass Grafting: Using…

Objective To estimate a safe minimum hospital volume for hospitals performing coronary artery bypass graft (CABG) surgery.


Risk Of Post-Surgical Death Higher Among Patients In Low-, Middle-Income Countries Compared…

Reuters Health: Death after surgery three times more likely in lower-income countries “How many people survive after emergency surgery is one measure of the quality of care they have access to, and post-surgery death rates in low- and middle-income countries suggest quality needs to be better, researchers say. Using mortality rates within 24 hours and…More


Tracking perioperative mortality and maternal mortality: challenges and opportunities

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Access to surgery remains inequitable worldwide, with 5 billion people lacking safe and affordable surgical and anaesthesia care when needed.1 The Lancet Commission on Global Surgery was convened in 2013 to assess the state of surgery around the world, provide recommendations for improving access, and propose indicators for assessing national surgical systems. A key safety indicator is the perioperative mortality rate (POMR). This is defined by the Commission as the number of all-cause deaths before discharge in patients who have undergone a procedure in an operating theatre, divided by the total number of procedures, and presented as a percentage.


BMJ Report On Global Surgery Draws Attention To Multiple Challenges Of Providing Quality…

NPR: The Improvisational Surgeon: Cardboard Casts, No Power, Patients Galore “…A new report in BMJ Global Health says essentially that surgery has become the overlooked stepchild of global health. The authors say that five billion people lack access to proper surgical care and they argue the world needs to rethink the importance of surgery. ……More


Anaesthesia-related maternal mortality in low-income and middle-income countries: a…

The current international priority on strengthening health systems should address the risk factors such as general anaesthesia and rural setting for improving anaesthetic care in pregnant women.


The critical role of obstetric anaesthesia in low-income and middle-income countries

In the current issue of The Lancet Global Health, Soha Sobhy and colleagues1 have compiled the first systematic review and meta-analysis of anaesthesia-related maternal mortality in low-income and middle-income countries. They find that anaesthesia contributes 2·8% of all maternal deaths in these settings. Although this percentage is small, the overall frequency of anaesthesia-related maternal death is 300-fold higher for neuraxial anaesthesia and 900-fold higher for general anaesthesia than that reported for the USA (1·2 per 1000 women undergoing an obstetric procedure vs 3·8 per million, and 5·9 per 1000 vs 6·5 per million, respectively).


Surgery, Anesthesia Care Integral To Achieving SDGs

Los Angeles Times: The sustainable development goals and surgery: Is a ‘moon shot’ the answer? John Meara, Kletjian professor of global surgery at Harvard Medical School and co-chair of the Lancet Commission on Global Surgery, and Nakul Raykar, chief fellow of the program in global surgery and social change at Harvard Medical School “…The past…More


Road traffic fatalities in selected governorates of Iraq from 2010 to 2013: prospective…

The insurgency tactics that characterize modern warfare, such as suicide car bombs and roadside bombs, have the potential to significantly impact road traffic injuries in conflict affected-countries.


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