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ORIGINAL ARTICLE
Year : 2020  |  Volume : 17  |  Issue : 3  |  Page : 90-94

Perioperative management of circumcision in children: Is there a difference between African and European hospitals?


1 Department of Women's and Children's Health, Paediatric Surgery Unit, Padua University Hospital, University of Padua, Italy
2 Department of Reproduction and Growth, Paediatric Surgery Unit, Arcispedale Sant'Anna, University of Ferrara, Italy
3 Department of Emergency, Anaesthesiology and Intensive Care Unit, Arcispedale Sant'Anna, University of Ferrara, Italy
4 Department of Surgery, Paediatric Hospital of Sao José em Bor, Bissau, Guinea Bissau
5 Department of Women's and Children's Health, Anaesthesioloy and Intensive Care Unit, Padua University Hospital, University of Padua, Italy

Correspondence Address:
Dr. Filippo Ghidini
Padua General Hospital, Via Nicolò Giustiniani, 35121, Padua
Italy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajps.AJPS_24_20

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Context: The circumcision is the most frequent procedure in paediatric surgery worldwide, performed for medical and ritual purposes. In developing countries, because of the difficult accessibility to healthcare, even a common procedure could be unsafe. Aims: The aim of the article is to compare the perioperative and anaesthesiological management of circumcision in children between two Italian and two sub-Saharan African hospitals. Materials and Methods: Medical records of paediatric circumcision from January 2014 to December 2016 have been reviewed. The involved hospitals were: Padua (Italy), Ferrara (Italy), Sao José em Bor (Guinea Bissau) and Yaoundé (Cameroun). Results: In Padua, 77 circumcisions were performed, 19 of these (24.6%) were ritual. In 75 children (97.4%), locoregional anaesthesia (LRA) together with sedation was used; only one complication (1.3%) occurred. In Ferrara, 200 interventions were done, 140 (70%) ritual; general anaesthesia was administered to 183 (93.5%) patients. There were five complications (2.5%). In Bissau, 53 procedures were performed, 21 (39.6%) ritual; in 34 children (64.1%), LRA with sedation was preferred. Two complications (3.8%) were reported. In Yaoundé, 60 children were circumcised, 15 (25%) for ritual purposes; in 51 (85%), only LRA was performed; there was only one (1.7%) complication. In the African hospital, no post-operative analgesia was administered. Conclusion: Despite the different anaesthesiological techniques, the study shows no difference in rate of complications for the in-hospital setting. Training of the local medical team in pain management and post-operative care should be emphasised.


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