Empowering Tomorrow's Cancer Specialists: Evaluating the Co-creation and Impact of Malawi's First Surgical Oncology Summerschool.

Annually more than 1 million newly diagnosed cancer cases and 500,000 cancer-related deaths occur in Sub Saharan Africa (SSA). By 2030, the cancer burden in Africa is expected to double accompanied by low survival rates. Surgery remains the primary treatment for solid tumours especially where other treatment modalities are lacking. However, in SSA, surgical residents lack sufficient training in cancer treatment. In 2022, Malawian and Dutch specialists co-designed a training course focusing on oncologic diseases and potential treatment options tailored to the Malawian context. The aim of this study was to describe the co-creation process of a surgical oncology education activity in a low resource setting, at the same time attempting to evaluate the effectiveness of this training program. The course design was guided and evaluated conform Kirkpatrick's requirements for an effective training program. Pre-and post-course questionnaires were conducted to evaluate the effectiveness. Thirty-five surgical and gynaecological residents from Malawi participated in the course. Eighty-six percent of respondents (n = 24/28) were highly satisfied at the end of the course. After a 2-month follow-up, 84% (n = 16/19) frequently applied the newly acquired knowledge, and 74% (n = 14/19) reported to have changed their patient care. The course costs were approximately 119 EUR per attendee per day. This course generally received generally positively feedback, had high satisfaction rates, and enhanced knowledge and confidence in the surgical treatment of cancer. Its effectiveness should be further evaluated using the same co-creation model in different settings. Integrating oncology into the regular curriculum of surgical residents is recommended.

[Inguinal hernia in children: easily incarcerated]. / Liesbreuk bij kinderen: snel beklemd.

Inguinal hernia in children is caused by an incomplete obliteration of the vaginal process during the embryological development. The vaginal process can thus become a hernia sac that often contains bowel and in girls, an ovary. The diagnosis of inguinal hernia is made by history and physical examination. According to current guidelines surgical repair should be performed without delay to avoid incarceration, which gives a high risk of complications, including testicular atrophy and ischemia of vital organs. However, patients are regularly not referred adequately. We present three cases of children who developed complications of a non-repaired inguinal hernia. Additionally, the data of all children with a congenital inguinal hernia, surgically treated from January 2018 until August 2019 show that out of 243 children 13.6% presented acutely with an incarcerated inguinal hernia. Another 6% received a wrong advice from their primary care doctor and was not referred to a (pediatric) surgeon.

Long-term follow-up of incontinence and urge complaints after intensive urotherapy in childhood (75 patients followed up for 16.2-21.8 years).

OBJECTIVE: To reassess the incontinence and urge complaints in adults who had undergone inpatient urotherapy during childhood and compare the results with the short-term outcomes. METHODS: From 1987 to 1990, 95 children (13 boys and 82 girls; age 6-17 years) underwent hospitalized urotherapy to treat functional lower urinary tract symptoms. This group was traced and a questionnaire was administered by telephone. The long-term data on incontinence and urge complaints were compared with the results at 6 months after training. RESULTS: Of the 95 patients, 92 were traced, and a cohort of 75 could be analyzed. At long-term follow-up (mean 17.9 years), of the 75 patients, 63 (84%) had a good, 8 (11%) a moderate, and 4 (5%) a poor outcome. At short-term follow-up, 56 of the current 75 patients had had a good outcome, and at long-term follow-up, 47 of these 56 patients still had a good score. However, during the intervening period, 3 of these 56 patients developed incontinence recurrence and scored a poor result, and 6 others scored a moderate result. Originally, after 6 months of follow-up, 7 patients had had a moderate outcome; 5 of these had improved to good, 1 still scored moderate, and 1 had deteriorated over time to poor. Twelve patients had originally had a poor outcome at short-term follow-up. Of these, 11 had spontaneously improved to good and 1 to moderate. CONCLUSION: If the original outcomes of pediatric intensive inpatient urotherapy are good, they tend to remain so over time in most patients.