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Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review

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Italian Agency for Development Cooperation, Khartoum 11111, Sudan
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The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Vision and Eye Research Institute, Anglia Ruskin University, Cambridge CB1 1PT, UK
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Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, Vienna 1010, Austria
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Department of Surgery, Central Hospital of Beira, Beira 13016, Mozambique
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Department of Surgery, Catholic University of Mozambique, Beira 13016, Mozambique
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Department of Surgery and Organ Transplantation, University of Padua, 35125 Padua, Italy
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Department of Urology, The Queen Elizabeth Hospital, King’s Lynn PE30 4ET, UK
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Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90121 Palermo, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Int. J. Environ. Res. Public Health 2021, 18(11), 5796; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115796
Received: 4 April 2021 / Revised: 24 May 2021 / Accepted: 26 May 2021 / Published: 28 May 2021
(This article belongs to the Special Issue Health and Well-Being in Vulnerable Communities)
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. View Full-Text
Keywords: laparoscopy; low-income countries; minimal invasive surgery laparoscopy; low-income countries; minimal invasive surgery
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MDPI and ACS Style

Pizzol, D.; Trott, M.; Grabovac, I.; Antunes, M.; Colangelo, A.C.; Ippoliti, S.; Ilie, C.P.; Carrie, A.; Veronese, N.; Smith, L. Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review. Int. J. Environ. Res. Public Health 2021, 18, 5796. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115796

AMA Style

Pizzol D, Trott M, Grabovac I, Antunes M, Colangelo AC, Ippoliti S, Ilie CP, Carrie A, Veronese N, Smith L. Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review. International Journal of Environmental Research and Public Health. 2021; 18(11):5796. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115796

Chicago/Turabian Style

Pizzol, Damiano, Mike Trott, Igor Grabovac, Mario Antunes, Anna C. Colangelo, Simona Ippoliti, Cristian P. Ilie, Anne Carrie, Nicola Veronese, and Lee Smith. 2021. "Laparoscopy in Low-Income Countries: 10-Year Experience and Systematic Literature Review" International Journal of Environmental Research and Public Health 18, no. 11: 5796. https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18115796

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