Abstract：
BACKGROUND: Minimally invasive surgery, including laparoscopy and robotics, has significantly improved general surgical (GS) practice globally. While robot-assisted GS practice is yet to be adopted in the majority of Africa, laparoscopy has been utilized to improve surgical outcomes. This study aims to review the laparoscopic GS procedures (LGSPs) performed and evaluate outcomes such as conversion to open surgery, morbidity, and mortality in Africa.
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.
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.
摘要：
背景：微创手术，包括腹腔镜和机器人，在全球范围内显着改善了普通外科（GS）实践。虽然非洲大部分地区尚未采用机器人辅助的GS实践，腹腔镜检查已被用于改善手术效果。本研究旨在回顾腹腔镜GS手术（LGSP）进行和评估结果，如转换为开放手术，发病率，和非洲的死亡率。
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.
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.
