METHODS: Four databases (PubMed, Google Scholar, WoS, and AJOL) were searched, identifying 8022 publications. Following screening, 40 studies across Africa that reported LGSPs (n ≥ 2) performed and outcomes met the inclusion criteria. A meta-analysis conducted using R statistical software estimated the pooled prevalences with the 95% CI of conversion, morbidity, and mortality.
RESULTS: A total of 6381 procedures performed in 15 African countries were analyzed in this study. Majority, 72.89%, of the procedures were performed in Senegal, South Africa, and Nigeria. The major procedures performed were cholecystectomy (37.09%), appendicectomy (33.36%), and diagnostic laparoscopy (9.98%). The meta-analysis revealed a conversion rate of 5% [95% CI: 4, 7]. Adhesion (28.13%), hemorrhage (16.67%), technical difficultly (12.50%), and equipment failure (11.46%) were the predominant indications for conversion. Surgical site infection (42.75%) was the major cause of morbidity. The prevalences of morbidity and mortality were 7% [95% CI: 5, 10] and 0.12% [95% CI: 0, 0.29], respectively.
CONCLUSIONS: A wide range of basic and advanced LGSPs were performed. The outcomes obtained indicate successful implementation of the laparoscopic approach. Importantly, this study serves as a foundational work for further research on minimally invasive surgery in Africa.
方法:四个数据库(PubMed,谷歌学者,WOS,和AJOL)被搜索,识别8022种出版物。筛选后,在非洲进行了40项报告LGSP(n≥2)的研究,结果符合纳入标准。使用R统计软件进行的荟萃分析以95%的转换CI估计了合并的患病率,发病率,和死亡率。
结果:本研究共分析了在15个非洲国家进行的6381例手术。多数,72.89%,这些程序在塞内加尔进行,南非,和尼日利亚。主要手术为胆囊切除术(37.09%),阑尾切除术(33.36%),和诊断性腹腔镜检查(9.98%)。荟萃分析显示转化率为5%[95%CI:4,7]。附着力(28.13%),出血(16.67%),技术难度(12.50%),设备故障(11.46%)是转换的主要指征。手术部位感染(42.75%)是发病的主要原因。发病率和死亡率分别为7%[95%CI:5,10]和0.12%[95%CI:0,0.29],分别。
结论:进行了广泛的基础和高级LGSP。获得的结果表明腹腔镜方法的成功实施。重要的是,本研究为非洲微创手术的进一步研究奠定了基础.