Evaluation de deux programmes de missions de chirurgie et de leur impact sur l’amelioration de l’acces aux soins chirurgicaux

Objectif : Evaluer deux programmes de missions de chirurgie et leur impact sur l’acces aux soins chirurgicaux. Methodologie : Nous avons compile les donnees des missions de chirurgie de l’association Hope au CHU Sylvanus Olympio et d’une ONG italienne a l’Hopital Sainte Bakhita et avons evalue leurs resultats. Resultats : Mission Hope : l’objectif etait le transfert de competence. Au total 52 patients ont ete pris en charge en 3 missions (2013, 2014 et 2016). La pathologie herniaire etait predominante avec 20 patients. La procedure a ete faite en coelioscopie dans 23 cas (44,23%). La morbidite etait de 3,85%. La satisfaction etait totale et la realisation de la cholecystectomie et de la cure herniaire par coelioscopie etait desormais courante de meme qu’une autonomisation dans la chirurgie pancreatique. Mission a l’Hopital Sainte Bakhita : l’objectif etait d’apporter a la population des soins chirurgicaux. En 12 missions de 2011 a 2019, 714 patients ont ete pris en charge. Les cures herniaires et les cures d’hydrocele etaient les interventions les plus realisees avec respectivement 86,46% et 5,06%. Les interventions etaient realisees sous rachianesthesie dans 93,28% des cas. La morbidite etait de 9,94% et etaient dominees par les hematomes des bourses (63,38%). Conclusion : les missions de soins chirurgicaux apportent un benefice certain aux populations a court terme et a l’amelioration de la pratique chirurgicale. Elles posent le probleme de perennisation et leur impact a long terme reste a prouver. Mots-cles : missions chirurgicales, acces aux soins, transfert de competences, hernies, Togo   English Title: Evaluation of two surgical mission programs and their impact on improving access to surgical care Objective: Evaluate two surgical mission programs and their impact on access to surgical care.Methodology: We compiled data from the surgical missions of the Hope association at the Sylvanus Olympio University Hospital and an Italian NGO at Sainte Bakhita Hospital and evaluated their results. Results : Mission Hope: The objective was the transfer of competence. A total of 52 patients were treated in 3 missions (2013, 2014 and 2016). Hernia pathology was predominant with 20 patients. The procedure was performed by laparoscopy in 23 cases (44.23%). Morbidity was 3.85%. The satisfaction was total and the realization of cholecystectomy and hernia surgery by laparoscopy was now common, as was empowerment in pancreatic surgery. Mission to St. Bakhita Hospital: the objective was to provide surgical care to people. In 12 missions from 2011 to 2019, 714 patients were treated. Hernia and hydrocele surgery were most commonly performed with 86.46% and 5.06% respectively. Surgery were performed under spinal anesthesia in 93.28% of cases. Morbidity was 9.94% and was dominated by hematoma (63.38%). Conclusion: Surgical care missions give significant benefits to populations in the short term and to the improvement of surgical practice. They pose the problem of sustainability and their long-term impact has yet to be proven. Keywords: surgical missions, access to care, transfer of competences, hernias, Togo