Laparoscopy in low-income countries: 10-years experience and systematic literature review

Pizzol, Damiano and Trott, Mike and Grabovac, Igor and Antunes, Mario and Colangelo, Anna C. and Ippoliti, Simona and Ilie, Cristian P. and Carrie, Anne and Veronese, Nicola and Smith, Lee (2021) Laparoscopy in low-income countries: 10-years experience and systematic literature review. International Journal of Environmental Research and Public Health, 18 (11). p. 5796. ISSN 1660-4601

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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; I2 = 85.7%) and a significantly lower risk of infection (OR = 0.53; 95% CI 0.43–0.65; I2 = 0.00%). The pooled SMD in operation duration in laparoscopic vs. open appendectomy was 0.58 (95% CI −0.00; 1.15; I2 = 96.52), while the pooled SMD in hospitalization days was −1.35 (95% CI −1.87; −0.82; I2 = 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.

Item Type: Journal Article
Keywords: Laparoscopy, Low-income countries, minimal invasive surgery
Faculty: Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 27 May 2021 09:28
Last Modified: 09 Sep 2021 18:50

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