Priority ranking of pediatric surgical pathologies at Amirou Boubacar Diallo National Hospital: Retrospective review of 15 years of activities.

Abstract

Introduction :
Faced with the increased demand for surgical care, priorities must be identified. The objective of this study was to classify pediatric surgical pathologies operated on at the Amirou Boubacar Diallo National Hospital (HNABD) according to their level of priority.

Patients and method :
This was a descriptive retrospective study carried out in the pediatric surgery department of HNABD over a period of 15 years (from January 1, 2005 to December 31, 2019) and focused on all pathologies and their operative indications in patients aged 0 to 15 years. Their priority was established by the use of 2 classifications. On the one hand, the classification of Mock et al, of public health care, approach, which distinguishes 3 categories of pathologies of decreasing priority and, on the other hand, that of the British Association of Pediatric Surgeons which identifies 2 fields in pediatric surgery (specialized and general ).

Results :
During the study period, 5362 patients were collected. The median age was 50.5 months, and males accounted for 62.3% of patients (n = 3340). A total of 5593 operations were performed, of which 73.3% (n = 4105) were general pediatric surgery. It exclusively concerned priorities 1 and 2 surgical pathologies (hernias of the anterior abdominal wall, cryptorchidism, and visceral surgical emergencies). Specialized pediatric surgery represented 26.7% (n = 1488) and concerned surgical priorities 2 and 3 (neonatal surgery, anorectal malformations, Hirschsprung's disease, pediatric urology and oncology).

Conclusion :
In our practice 2 distinct groups of priority pathologies are encountered: frequent pathologies whose treatment has a significant effect on public health, on the one hand, and rarer and more serious conditions requiring more specialized care, on the other hand.