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Purpose <p>In resource-limited hospitals, pediatric neurosurgery is performed by general surgeons (GS) and neurosurgeons (NS), but the provider-specific impact remains unclear. This study compares pediatric neurosurgery cranial cases managed by GS and NS at a regional referral center in Southern Ethiopia.</p> Methods <p>Cranial operations in patients &lt; 18&#xa0;years (January 2020–October 2024) were retrospectively reviewed. Data included demographics, travel, delay (&gt; 12&#xa0;h), procedure type, and early outcomes (complications, length of stay [LOS]). Procedures were classified as routine (elevation, washout/I&amp;D) or complex (shunt, craniotomy). Chi square with Yates and Mann‑Whitney U tests compared groups. Multivariable logistic regression adjusted for age, sex, and delay.</p> Results <p>Among the 75 patients, 36 (48%) were treated by NS and 39 (52%) by GS. Routine operations predominated in GS (69.2% vs 55.6%) while complex procedures were more frequent in NS (36.1% vs 5.1%). LOS was comparable (4&#xa0;days, p = 0.772), as were delays (41.0% GS vs 44.4% NS, p = 0.818) and complications (12.8% GS vs 19.4% NS, χ2 test with Yates p = 0.641). Complication rates for routine procedures were similar between groups (elevation 0% and washout/I&amp;D 40%; p = 1.000), and although unadjusted rates were higher in the NS cohort for complex cases (craniotomy 66.7% vs 30.0%; shunt 23.1% vs 0%), these differences were not statistically significant (p = 0.510 and p = 1.000, respectively), with multivariable adjustment likewise showing no provider effect (aOR 1.25, 95% CI 0.27–5.78; p = 0.773).</p> Conclusions <p>With appropriate training, GS achieved early outcomes comparable to NS for routine and complex pediatric cranial operations. The absence of significant differences in complications supports structured task‑sharing and skills-based mentorship to expand neurosurgical care in resource-limited settings.</p>

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Comparative outcomes for pediatric cranial procedures by general surgeons and neurosurgeons in a tertiary care hospital in Ethiopia

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月27日

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  • Cleresa Renee Roberts,
  • Oumou Kalsoum Mbacke,
  • Divine Nwafor,
  • Emily Dunbar,
  • Abhinav Kareddy,
  • Maya Parker,
  • Joy Pierson,
  • Bereket Hailu Mekuria,
  • Heather Stevens Spader

摘要

Purpose

In resource-limited hospitals, pediatric neurosurgery is performed by general surgeons (GS) and neurosurgeons (NS), but the provider-specific impact remains unclear. This study compares pediatric neurosurgery cranial cases managed by GS and NS at a regional referral center in Southern Ethiopia.

Methods

Cranial operations in patients < 18 years (January 2020–October 2024) were retrospectively reviewed. Data included demographics, travel, delay (> 12 h), procedure type, and early outcomes (complications, length of stay [LOS]). Procedures were classified as routine (elevation, washout/I&D) or complex (shunt, craniotomy). Chi square with Yates and Mann‑Whitney U tests compared groups. Multivariable logistic regression adjusted for age, sex, and delay.

Results

Among the 75 patients, 36 (48%) were treated by NS and 39 (52%) by GS. Routine operations predominated in GS (69.2% vs 55.6%) while complex procedures were more frequent in NS (36.1% vs 5.1%). LOS was comparable (4 days, p = 0.772), as were delays (41.0% GS vs 44.4% NS, p = 0.818) and complications (12.8% GS vs 19.4% NS, χ2 test with Yates p = 0.641). Complication rates for routine procedures were similar between groups (elevation 0% and washout/I&D 40%; p = 1.000), and although unadjusted rates were higher in the NS cohort for complex cases (craniotomy 66.7% vs 30.0%; shunt 23.1% vs 0%), these differences were not statistically significant (p = 0.510 and p = 1.000, respectively), with multivariable adjustment likewise showing no provider effect (aOR 1.25, 95% CI 0.27–5.78; p = 0.773).

Conclusions

With appropriate training, GS achieved early outcomes comparable to NS for routine and complex pediatric cranial operations. The absence of significant differences in complications supports structured task‑sharing and skills-based mentorship to expand neurosurgical care in resource-limited settings.