Cancellation of elective surgical cases in a nigerian teaching hospital: Frequency and reasons.

BACKGROUND: Dwindling economic resources and reduced manpower in the health sector require efficient use of the available resources. Day of surgery cancellation has far reaching consequences on the patients and the theatre staff involved. Full use of the theatre space should be pursued by every theatre user. OBJECTIVE: The study aimed to report on the rates and causes of day of surgery cancellation of elective surgical cases in our hospital as a means towards proffering solutions. MATERIALS AND METHODS: It was a retrospective study of all elective cases that were booked over a 15-month period from January 2016 to March 2017. Cancellation was said to have occurred when the planned surgery did not take place on the proposed day of surgery. Cancellations were categorized into patient-related, surgeon-related, hospital-related and anesthetist-related. Reasons for the cancellations were documented. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 22. Variables were compared using Chi-square tests. A value of P < 0.05 was considered statistically significant. RESULTS: During the 15-month period, a total of 1296 elective surgeries were booked. Of this, 118 (9.1%) cases were cancelled. Patient-related factor was the most common reason (47.5%) followed by surgeon-related factor (28%). Lack of funds was the most common patient related-reason for cancellation. Majority of the cancelled cases were general surgical cases (36.4%) followed by orthopedics (25.4%) and urology (11%). Seventy percent of the cancelled cases were first and second on the elective list. CONCLUSION: The cancellation rate in this study is high. The reasons for these cancellations are preventable. To ensure effective use of the theatre, efforts should be made to tackle these reasons.

Postintubation tracheal stenosis: Surgical management.

Postintubation tracheal stenosis (PITS) is a known complication of endotracheal intubation or tracheostomy. It is the most common indication for tracheal resection/reconstructive surgery. Despite technological improvement and skilled patient care in the ICU, PITS still constitutes an important group of iatrogenic sequela after intubation. With increasing number of patients requiring ICU admission and mechanical ventilation in Nigeria, it is important that this complication is prevented from occurring. The care of such patients often is technically challenging. The successful management by resection and end-to-end anastomosis of a 37-year-old man presenting with 2 cm length of severe tracheal stenosis of 4 mm luminal diameter following prolonged endotracheal intubation and who had had repeated bronchial dilatation is presented.