Challenges and outcome of cranial neuroendoscopic surgery in a resource constrained developing African country

Abstract

Highlighted are the myriad obstacles which interface the successful set up of neuroendoscopy service especially in resource-constrained settings. Endoscopic procedures become safer with experience and complications reduce significantly after a steep learning curve.

Current trends and challenges: The landscape of perioperative mortality in intracranial surgeries in low‐ and middle‐income settings: A narrative review

“…In the African context, the literature reveals a broad spectrum of POMRs, with rates ranging between 2.5% and 39.1% for an assortment of intracranial interventions and pathologies. 1,4,[13][14][15][16][17][18] This stands in sharp contrast to the trends observed in North America and Europe, where analogous intracranial surgical interventions have consistently manifested markedly reduced POMRs. [19][20][21][22][23] Notably, certain studies within these developed regions have even reported an absence of perioperative mortalities.…”

“…Notably, training programs emphasizing the technical facets of surgical interventions, such as neuroendoscopy, have been instrumental in mitigating postoperative complications. 4 Neurosurgical advancements in LMICs have greatly benefited from international collaborations. These alliances, especially with prominent global institutions, provide crucial monetary support, resources, and skill enhancement.…”

“…Inadequate postoperative monitoring and access to rehabilitation services often lead to suboptimal recovery and an increased risk of complications. 4,6,12 Similarly, poor preoperative evaluation and preparation, including comprehensive patient assessment, and exhaustive preoperative imaging, pose further challenges to intracranial surgeries in LMICs. 4,6,12 In light of challenges, this review aims to highlight the principal contributors to POM in intracranial surgeries within LMICs and offer recommendations to address these challenges, fostering improved patient outcomes, enhanced safety measures, and equitable access to high-quality neurosurgical care.…”

“…Addressing POM in LMICs poses several challenges. Limited access to healthcare, socioeconomic disparities, and inadequate preventive measures collectively contribute to the increased demand for intracranial surgeries in LMICs 4,6,9 . The provision of comprehensive surgical care for intracranial diseases within these countries encounters obstacles such as limited availability of essential resources and diagnostic technologies.…”

The Implications of Global Neurosurgery for Low- and Middle-income Countries: The Case of Cameroon

“…LMICs carry most of the burden of neurosurgical diseases and do not have enough resources to meet the local neurosurgical needs [23,24], yet clinical guidelines are developed in high-income countries where the bur-den of disease and the resources available differ from those in LMICs. For example, the most prevalent neurosurgical diseases, traumatic brain injury, stroke, and epilepsy, occur mostly in LMICs [10] where there is a lack of resources, and patients face delays in seeking care, reaching care, and receiving care.…”