Surgery

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    30 Day Perioperative Outcome and Associated Factors For Morbidity and Mortality of Patients that Undergo Elective Surgical Intervention for Colonic Cancer in Tikur Anbesa and Zewditu Memorial Hospital: A Cross-Sectional Prospective Study
    (Addis Ababa University, 2024-12-10) Adamzer Mulugeta; Abel Shiferaw
    Colorectal cancer remains a significant global health challenge, particularly in Ethiopia, where the incidence is rising. With this rise has come the increment of surgeries being done with curative intent with subsequent implications on morbidity and mortality of patients.
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    30 day’ Post-operative complicationsof Intracranial Meningioma Surgery
    (Addis Abeba University, 2020-01) Sileshi, Dagmawi; Kasahun, Azarias( MD, FCS (ECSA), Assistant professor)
    Background: Meningioma is the most common primary intracranial tumor. Even though different management options exist in modern medicine, surgery is still the only cure for this benign tumor. Surgical options are not without risk. Identifying and predicting the short-term complications in an Ethiopian setup might be useful in the decision-making process before surgery for our patients. This study uses a prospective design that aims to assess 30 days of posoperative complications of intracranial meningioma. Methods: Aprospective study that was conducted at TASH, ZMH & MCM hospital between November 1, 2019, and September 1, 2020. Assessment of postoperative complications was determined in-person using a standard questionnaire in both inpatient & outpatient setup. For the investigation, pathology & Intraoperative findings data were collected from medical charts, radiology, and pathology archives.Data were checked for completeness and quality control aftewhich, it was entered on SPSS version 21 for analysis using logistic regression. Results:A total of 77 patients were enrolled in the study. The mean age of the patients was 40.94 years. 71 (92%) patients presented with headache and 62 (80.5%) patients had one or more focal neurologic deficits. Tumor was classified based on location and size. 47 (61%) of the tumors were skull base tumors.The surgical mortality rate which was defined as death within one month was 9.1%. Among all patients, 37 (48.1%)had one or more postoperative complications of which new-onset or worsened focal deficit was the commonest. A significant association was seen between skull base tumors and postoperative complications in both bivariate and multivariate analyses witha p-value of 0.01 (OR=5.79, 95% CI: 2.061-16.312. Conclusion: Even though the complications and mortality rates were high, surgery led to symptom improvement in a large proportion of patients. Skull base meningioma, anesthesia time more than 5 hours, and blood loss more than 1000ml hada significant association with postoperative complications.
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    A 2 Years Retrospective, Observational Cohort Study on use of Drains and Post-Operative Complications in Complicated Acute Appendicitis at ZMH and MH
    (Addis Ababa University, 2024-10-01) Dereje Atnaw; Abebe Alemayehu
    Background: Complicated acute appendicitis is a significant surgical challenge, usually managed with prophylactic drains to reduce post -operative complications. However, the benefit of drain usage remains controversial. Objective: This study aimed at evaluating the role of drains in managing complicated acute appendicitis by analyzing their impact on post – operative complications, recovery, and hospitalization time. Methods: A two-year retrospective observational cohort study was conducted on 209 patients with complicated acute appendicitis at MH and ZMH. We categorized patients into two groups: patients with drains (n=104) and patients without drains (n=105). Then we analyzed Data’ son hospitalization time, post – operative fever, surgical site infection (SSI), residual collections, and reoperation rates. Results: Patients in drain group had longer hospitalization times (mean of 6.44 days) compared to those in no drain group (mean of 4.31 days). Post -operative fever (56.8% vs. 44.8%), SSI (39 .4% vs. 30 .5%), residual collections (6.7% vs. 3.8%), and reoperation rates (5.8% vs. 2.9%) were all higher in the drain group. Despite these differences in drain vs no drain group, all patients were discharged improved. Conclusion: Routine use of drains does not consistently reduce post-operative complications; in contrary it may increase certain complications. A case-based drain placement, guided by intraoperative findings, is advised to optimize patient outcomes. And further research is needed to develop a clinical guideline.
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    A 2 years retrospective, observational cohort study on Use of Drains and Post-Operative Complications in Complicated Acute Appendicitis at ZMH and MH
    (Addis Ababa University, 2024-10-01) Dereje Atnaw; Abebe Alemayehu
    Background: Complicated acute appendicitis is a significant surgical challenge, usually managed with prophylactic drains to reduce post -operative complications. However, the benefit of drain usage remains controversial. Objective: This study aimed at evaluating the role of drains in managing complicated acute appendicitis by analyzing their impact on post – operative complications, recovery, and hospitalization time. Methods: A two-year retrospective observational cohort study was conducted on 209 patients with complicated acute appendicitis at MH and ZMH. We categorized patients into two groups: patients with drains (n=104) and patients without drains (n=105). Then we analyzed Data on hospitalization time, post – operative fever, surgical site infection (SSI), residual collections, and reoperation rates. Results: Patients in drain group had longer hospitalization times (mean of 6.44 days) compared to those in no drain group (mean of 4.31 days). Post -operative fever (56.8% vs. 44.8%), SSI (39 .4% vs. 30 .5%), residual collections (6.7% vs. 3.8%), and reoperation rates (5.8% vs. 2.9%) were all higher in the drain group. Despite these differences in drain vs no drain group, all patients were discharged improved. Conclusion: Routine use of drains does not consistently reduce post-operative complications; in contrary it may increase certain complications. A case-based drain placement, guided by intraoperative findings, is advised to optimize patient outcomes. And further research is needed to develop a clinical guideline.
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    A cross sectional descriptive study on oral cancer awareness among patients that visited department of dentistry and oral and maxillofacial surgery unit at Tikur Anbesa Specialized Hospital , Addis Ababa University
    (Addis Ababa University, 2023-07) Abera,Feven; Garoma,Gelana(Ass.Prof. ,OMFS); Dejene,Demerew (Ass.Prof. ,OMFS)
    Background: Oral cancer is a malignant tumor that develops in a part of the mouth. It may be on the surface of the tongue, the inside of the cheeks, the roof of the mouth (palate), floor of mouth, the lips or gums. It is a preventable disease. Its occurrence is mostly due to lifestyle. Knowledge of the signs and symptoms of oral cancer may well aid in early diagnosis and treatment. This is bound to increase in survival rate. Objectives: To assess the awareness of Oral cancer among patients that visited department of Dentistry and maxillofacial surgery at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia. Methods: A hospital based cross-sectional study; interviewer-administered questionnaire was conducted amongst 221 adult patients attending the Tikur Anbesa Hospital during June, 2023. A 29-item questioner which has 3 sections: demographics, knowledge of risk factors and knowledge of sign & symptoms of oral cancer were used during data collection. Time frame: The study was conducted from June 1 up to June 30, 2023 Result: A total of 221 patients visited the department during the study period. The female to male ratio was 1.51:1 & the mean age of patients was 37.09 years with standard deviation ±13.77. Majority of the participants (86.4%, N=191) were urban & 57.9% (N=128) of the participants were employed. About 52.0% (N=115) of the participants had a basic education or have accomplished primary & secondary level of school. The majority of the participants 65.2% (N=144) didn‟t have any habit of substance use & 75.1% (N=166) of the participants did not hear of oral cancer prior to this research. A total of 45.2% (N=100) of the participants demonstrated good knowledge of signs & symptoms of oral cancer whereas a total of 44.3% (N=98) of the participants demonstrated good knowledge of risk factors of oral cancer. Conclusion: This research demonstrated a lack of public awareness & knowledge about oral cancer. Different measures should be taken to improve public awareness of oral cancer. Dentists and health workers should do more in educating the public.
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    A cross-sectional descriptive study on knowledge, attitude and perception of oral and maxillofacial surgery specialty among healthcare professionals in Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia
    (Addis Ababa University, 2023-09) Tibebu, Hiwot Demisachew; Negussie,Samson (PhD); Adula, Surafel (PhD)
    Background: Oral and maxillofacial surgery evolves around the head and neck region, and acts as a connecting bridge between medical and dental specialties. In many health services communities, the scope of oral and maxillofacial surgery (OMFS) as a discipline is frequently not probably understood. Good awareness of OMFS among different branches of health service providers is essential for better referral strategies and will be for the benefit of the patient. Objective: The main objective of this study is to assess the knowledge, attitude and perception of oral and maxillofacial surgery specialty among healthcare professionals at TikurAnbessa Specialized Hospital in Addis Ababa, Ethiopia. Method: A descriptive cross-sectional study design and a convenient sampling method isused. Self-administered questionnaires were prepared and filled out by the healthcare professionals. Descriptive statistics such as demographic data, knowledge, attitude and perception of study participants from their responses of the questionnaire were recorded and analyzed using SPSS version 25 software. Time frame: The study was conducted from December, 2022 to July, 2023. Result: A total of 125 healthcare professionals were participated in this study. Out of which, 75 were males and 50 were females. Most of participants were in the age range between 20 and 30 years. And, most of them have been in clinical practice in a range of 2 to 5 years. Regarding knowledge and attitude of healthcare professionals, the result of this study showed that 76 (60.8%) have poor knowledge and 49 (39.2) have good knowledge. Similarly, most participants have poor attitude towards oral and maxillofacial surgery specialty which accounts for about 79 (63.2%) of participants and 46 (36.8) of them have good attitude. On the contrary, the perception of healthcare professionals towards the level of oral and maxillofacial surgery service given in TikurAnbessa specialized hospital is good in majority of them (76, 60.8%) and the rest 49 (39.2%) participants have poor perception. Conclusion: The study concluded that there is poor knowledge and attitude of oral andmaxillofacial surgery specialty among study participants.
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    Acute Limb Ischemia Presentation and Outcome Among Cardiac Patients in Resource-Limited Setup, Single Institution Experience, Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2024
    (Addis Ababa University, 2024-12-13) Weini Tekle; Henok Teklesilasie
    Acute Limb Ischemia (ALI) is a sudden drop in limb perfusion, posing a threat to viability. Cardiac conditions such as atrial fibrillation, valvular disease, and ischemic heart disease are major risk factors. In resource-limited settings like Tikur Anbessa Specialized Hospital, understanding ALI presentation and outcomes in cardiac patients is crucial for improving management and reducing morbidity and mortality
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    Aerodigestive foreign body in pediatrics: a retrospective study in tertiary hospital
    (Addis Ababa University, 2023-07) Abebaw,Etsub; kiflu,Woubedil(Ass.Prof.)
    Objective – The aim of this research is to assess the outcome and complications of aero digestive foreign body and associated risk factors in pediatric patients in Tikur Anbesa Specialized Hospital. Method – The medical records of 302 children who were treated for an aero-digestive foreign body during a three-year period were reviewed at TASH. Patient’s demography (age, sex,adress), clinical data (Duration of symptoms, vomiting, dysphagia, cough ,fever, fast breathing, preoperative aspiration pneumonia,URTI), image finding, type of foreign body, type and length of the procedure, outcome, intra op and post-op complications ,rate of redo bronchoscopy procedure were analyzed using logistic regression. Results – The overall rate of removal of FBS in the 1st procedure was 97(95.1%) and 5(4.9%) pushed distally. 66(65.7%) removed with Magill’s forceps and esophagoscopy done in 36(35.3%) .28(27.5%) develop complications. from this 20(19.6%) accounted for minimal esophageal mucosal bleeding during the procedure.4 cases(3.9%) have esophageal perforation and managed with chest tube and antibiotics.one case(2.9%)had TEF and 2 managed conservatively.one patient TEF repair through cervical approach. One patient died post esophagoscopic removal of battery from esophagus with hemorrhagic shock 2ndary to AEF. With mortality rate of (1%). In patents with FBA rigid bronchoscopy done in 195(97.5%) and direct laryngoscopy with Magill’s in 5(2.5%).FB removal was not successful in 24(12%) of patients, 1 in laryngoscopic group and 22 in bronchoscopy group. During the procedure 122(61%) develop complications, majority were intra operative complications like laryngospasm in 46(23%), persistent intra operative hypoxia occurred in 93(46.5%), which was associated with intraop bradycardia in 43(21.5%) and intraoperative cardiac arrest in 9(4.5%). Minimal bleeding from the air way mucosa occurred in 13(6.5%) during the procedure. But there was significant bleeding from the air way and death in one patient during removal of sharp FB.in 12 (6%) of patients there was pus in the air way during removal of airway FB in 9(4.5%) pneumothorax occurred in 9(4.5%) of cases .one patient (0.5%) came with pneumothorax preoperatively. two patients had pneumomediastinum, Five (2.5%) develop BPF.72 (36%) had air way edema, 17(8.5%) developed HAP,. One patient (0.5%) develop HIE during the procedure iv Our analysis showed in patients with air way FB presence of preoperative infections (AOR 3.086; 95% CI, 1.486; 6.41, P=0.003 and desaturation at presentation (AOR 5.52; 95% CI, 2.555-11.925; P=0.000), had increased risk of complications .patients with complication had prolonged hospital stay (AOR 3.661; 95% CI, 1.327-10.104; P=0.012). Delayed presentation (>24 hours) (AOR 23.135; 95% CI, 4.44-120.54; P=0), sharp and battery foreign bodies (AOR 50.803; 95% CI, 5.742-449.49; P=0) were independent risk factors for occurrence of complications in esophageal FB. Conclusion – In patients with air way FB presence of preoperative infection and desaturation at presentation had increased risk of complications with significant association .patients with complication had prolonged hospital stay .Delayed presentation (>24 hours),sharp and battery foreign bodies radiolucent FB on imaging, were independent risk factors for occurrence of complications in esophageal FB in children.
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    Analysis of clinical presentation of prostatic cancer patients at TASH: Two-year retrospective cross-sectional study
    (Addis Ababa University, 2025-07) Muluneh,Sewunet; Melaku,Admassu(Ass.Prof.)
    INTRODUCTION: Prostate cancer is second most diagnosed cancer exceeded by lung cancer only across globe and it is fifth leading cause of cancer associated mortality. It is number one cause of cancer death in men in 48 countries which includes many countries in sub-Saharan Africa. In Ethiopia, it was the third most diagnosed cancer and eighth cause of cancer death in 2013 in both sexes. In Ethiopia, in 2019 and 2020, it was second leading cancer in incidence in males with reported new cases of 2,570 & 2,720 respectively. OBJECTIVE: The study describes clinical presentation of prostatic cancer patients seen at outpatient department of Urology unit of TASH from 31st December,2023 to 1st January ,2025 GC. METHODS: The study was two-year cross-sectional descriptive study on prostatic cancer patients seen at Urology unit of TASH, Addis Ababa, Ethiopia from 31st December, 2023 to 1st January, 2025 GC. The questionnaires were used extract data of study population from patients’ chart by data collectors to collect the necessary information and phone call was used to get additional information from patients. Data collected with kobo toolbox, entered to spreadsheet and analysed by SPSS version 26. The findings of the study were summarized with Descriptive statistics and results presented in the form of text, table, and chart. Pearson chi-square test, Bi variable and multi variable logistic regression analysis used to explore association between different variables. Significant associations were declared at P-value <0.05 on multi variable logistic regression analysis. Results: 98.4% of the patients were symptomatic at time of diagnosis with 97.7% having LUTS and 33. 9% having metastatic symptoms. 24.4% have locally advanced cancer and 34.2% have metastatic prostate cancer. The ISUP grade group 4 and 5 account for 97% of cases, PIRADS 4 and 5 account for 67.5% of cases and mean PSA at time of diagnosis was 285ng/ml. Conclusion: 98.4% of the patients were symptomatic at time of diagnosis. Majority of patients were diagnosed with advanced of stage prostate cancer with higher Gleason's score, higher PIRADS score and high PSA at time of diagnosis. On multimodal regression analysis, Gleason’s score has significant association with PIRADS score and digital rectal examination finding. TNM staging has significant association with residential area, educational status, presence of symptoms at presentation, PIRADS score and digital rectal examination in the study. Work plan and budget: The study was conducted from March, 2025 GC to May, 2025GC with total budget of 47,491.4 Ethiopian birr.
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    Analysis of Major Orthopedic Surgical Procedures at Black Lion Specialized Hospital, Addis Ababa University, Ethiopia
    (Addis Ababa University, 2024-10-17) Mengistu Gebeyehu; Biruk. L
    Musculoskeletal disease (MSD) is a major cause of disability in the global burden of disease, yet data regarding the magnitude of this burden in orthopedic surgical services in low and middle-income countries (LMICs) are lacking
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    Analysis of Postcholecystectomy Syndrome, Single Institution Experience, Zewditu Memorial Hospital, Addis Ababa, Ethiopia, 2024
    (Addis Ababa University, 2024-12-13) Bamlack Shewandagn; Sahlu Wondimu
    Gallstone disease ranks among the most prevalent surgical conditions, with cholecystectomy being the primary treatment for gallstones. Post-cholecystectomy syndrome (PCS) refers to a variety of symptoms that occur in patients following gallbladder removal
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    Assessment of adequacy of surgical resection for colorectal cancer at Tikur Anbessa specialized hospital from2016-2019, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2020-10) Nibret, Yonas; Seyoum, Nebyou(MD, Associate Prof. of Surgery); Kotisso, Berhanu(MD, Prof. of Surgery)
    Background: Colorectal carcinoma is a malignant neoplasm of the colon and rectum. It is the most common malignancy of the gastrointestinal tract. The enbloc removal of the presenting malignancy, to include adequate margins plus the lymphatic nodal basin, remains the hallmark of surgical treatment for cure. Adequate lymph node evaluation is required for proper staging of colorectal cancer, and the number of lymph nodes examined is associated with survival Objectives: To determine the adequacy of surgical resection of patients operated for colorectal cancer at Tikur Anbessa Specialized Hospital. Methods: A retrospective cross-sectional study was conducted by a review of the medical records of all patients who had undergone resection of colorectal cancer at Tikur Anbessa Specialized hospital from January 1, 2016 to December 31, 2019. The data was obtained from the patient’s record review; data was collected using a pretested questionnaire and checklist. Data were checked and entered into Epi data version 3.1 then exported to statically package for social science version 24 for analysis. Result: From the total of study participants above the half 48(53.3%) are male, with male to female ratio of 1.14:1. The majority 44(48.9%) of study participants were found in the age groups of <50 years followed by 50-64 years 26(28.9%).The mean of LN harvested was 10.35(SD ±7.86) with a maximum of 41 and a minimum of 0.And only40% of patients had Adequate LN harvested (≥12). female patients were 2.12 times more likely to have adequate LN harvested as compared to male patients with AOR=2.12(1.49-3.96). Similarly, patients found in the age group of ≥65 were less likely to have adequate LN harvested as compared to patients found in the age group of <50 years with AOR=1.22 (1.60-4.88). Those patients with an age group of ≥65 years were 2.04 times more likely to have radial Margin involvement as compared to others, while fixed tumors are 2.81 times more likely to have radial margin involvement relative to mobile tumors. Conclusion: In this retrospective study, we described the adequacy of nodal harvest in colorectal cancer and evaluated possible factors that may affect the adequacy nodal harvest. Only 40 % of the patients in this study have adequate nodal harvest based on current guidelines. Younger patients less than 50 years of age and female patients were associated with improved nodal harvest. In this study, age≥65 years and fixed tumors are more likely to have radial margin involvement.
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    Assessment of Characteristics and Outcome of Cardiac Patients who Underwent Open-heart Surgery at Cardiac Center of Ethiopia, FEB, 2009–DEC, 2020: Retrospective Cross Sectional Study
    (Addis Abeba University, 2021-07) Amdihun, Rekiya; Dr. Bezabih, Abebe(Cardiothoracic surgeon)
    Background: - The first successful open heart surgery using extracorporeal circulation technique was performed by John Gibbon in 1953 during an atrial septal defect closure. Cardiovascular diseases (CVD) are group of diseases and injuries that affect the cardiovascular system. As the main cause of death on the planet, cardiovascular disease (CVD) in all its forms is an important public health problem. Most commonly CVD affect the blood vessels of the heart and brain. In general they affect all people in both child and adulthood life. Objective:-The objective of this study is to assess characteristics and outcomes of patients who underwent open heart surgery from FEB, 2009 to DEC, 2020at cardiac center of Ethiopia. Method:-Institutional based cross-sectional study design was conducted. Sampling and Sample size determination: The sample size for the study was determined using single population proportion formula. And Simple random sampling retrospective chart review technique was used. RESULTS:-In this study a total of 320 patients were analyzed, from this 186 (58.1%)of the patients were female and 134(41.9%) were male. The majority of participants were found in the age group 6-18yrs 148(43.7%). The primary diagnosis from this study were ASD 54 (16.8%), VSD covered 42(13.1%), severe MR 40(12.5%). Only eight (2.5%) of patients had post-operative acute kidney injury and 5(1.6%) patients had post-operative bleeding. the immediate overall mortality were 3(0.9%). Conclusion and Recommendation: The present study had identified that more than half 58.1% of the patients were female. It also identified ASD the commonest CHDs followed by VSD. This study report that MV replacements were the most common valve surgery. Open heart surgery can be performed with excellent outcome in cardiac center of Ethiopia. We recommend that doing further research on associated factor for this outcome. That may better to know which variable has association for good outcome .and also quality improvement and increase number of surgeons is good for doing all the surgeries by local team.
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    Assessment of Coagulation Profile among Adult Cardiac Outpatient Department of Tikur Anbessa Hospital, Addis Ababa, Ethiopia.
    (Addis Abeba University, 2021-02) Fantahun, Ibrahim; Bezabeh, Abebe(MD, Cardiothoracic Surgery)
    Background; the coagulation process is initiated by platelets forming a plug at the location of the injury within few seconds of a breach in the vascular integrity. This constitutes the primary haemostatic mechanism. Secondary homeostasis is a multifaceted interaction between plasma coagulation factors, which results in the creation of fibrin strands strengthening the platelet plug. A hospital based cross sectional (retrospective chart review) study design was employed and simple random sampling techniques was used. Sample size is calculated by taking assumptions of 95% confidence level, there is no other study conducted related with this title to being use as a reference proportion so I took 50% (P=0.5) as a reference proportion. And adding 10 % nonrespondents rate. The total population under study, which means total patient number who attend cardiac clinic in last month, was 1000 so by using correction formula the sample size becomes 306. In this study we found that the mean INR value of a patient under study was 3.037 (SD: ±1.43) and the median was 2.9.While the quarantines was 2.0 – 3.65. According to our study, the data confirmed that the mean platelet count of the study unit was 282248(SD: ±89589). However, the mean PTT value of patients was 41.7 seconds (SD: ±11seconds). While the minimum PTT was 22 seconds and the maximum was 77 seconds. as this study is hospital based with limited representativeness population based studies are recommended.
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    Assessment of correlation between femoral canal length and olecranon to 5th fingertip measurement and its associated factors at Tikur Anbessa Specialized Hospital.
    (Addis Ababa University, 2024-02-01) Kassahun Anteneh; Misgana Temesgen
    Introduction: Accurate preoperative measurement of femoral nail length is crucial in orthopedic trauma surgery to avoid complications and reduce operative time. Various anthropometric methods have been used to estimate femoral length, but these typically require intact contralateral femurs, which is problematic in cases of bilateral fractures or deformities. Recently, forearm plus little finger length (O-FT) has been proposed as an alternative measurement, though its applicability across different populations, including Ethiopia, remains underexplored. Methods: This descriptive cross-sectional study was conducted at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, from June to September 2024, involving 151 adult volunteers without prior musculoskeletal deformities or trauma. The O-FT and the distance from the greater trochanter to the superior pole of the patella (GT-SP) were independently measured by two observers using a tape measure. Pearson's correlation, intraclass correlation coefficients (ICC), and multiple linear regression analyses were utilized to assess the correlation and demographic factors’ impact. Results: The average O-FT and GT-SP measurements for Observer 1 were 41.89 cm and 42.32 cm, respectively, while for Observer 2, they were 41.99 cm and 42.49 cm. Both measurements exhibited a strong positive correlation (r = .903 and r = .890, p < .001 for Observers 1 and 2, respectively), with excellent inter-observer reliability (O-FT ICC = 0.960, GT-SP ICC = 0.937). Demographic factors like age, sex, and BMI did not significantly affect the correlation (p > 0.05). Discussion: The findings confirm a strong correlation between O-FT and femoral canal length in the Ethiopian population, aligning with results from other regions. O-FT measurement is a reliable, non-invasive, and cost-effective alternative for preoperative planning of femoral fractures, especially in settings with limited imaging access. Future studies should investigate demographic variability and validate these findings in larger, more diverse populations.
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    Assessment of ERAS Protocol Implementation at Tikur Anbessa Specialized Hospital; An Observational Cross-Sectional Study from Jan. 1 to April 30, 2025.
    (Addis Ababa University, 2025-07) Kibret,Bekin Ayalew; Asefa,Zelalem(Consultant General Surgeon and Colorectal Surgery Subspecialist)
    Background: Enhanced Recovery After Surgery (ERAS) programs are multimodal perioperative care pathways designed to achieve early recovery for patients undergoing major surgery. While ERAS protocols have been extensively studied and implemented in high-income countries, their application in and middle-income countries (LMICs) is low and less well-documented. The International Surgical Outcomes Study (ISOS) and the African Surgical Outcomes Study (ASOS) highlighted the urgent need to address the quality gap in perioperative care in LMICs. Adaptation and effective implementation of ERAS is the best solution to achieve closing gap in perioperative care of a surgical patient including resource limited countries. Aim of this study is to assess ERAS implementation at TASH assuming that its practice is low at TASH Methods: An observational cross-sectional study was conducted on 52 colorectal patients who underwent elective surgery. Colorectal patients who will have isolated perianal procedure were excluded and no randomization technique was utilized. The data was cleaned and entered on SPSS version for analysis. The strength of associations was assessed using adjusted odds ratios (AOR) with 95% confidence intervals (CI), and a p-value of ≤0.05 was considered statistically significant. Result: A total of 52 patients were included in the study, with a male predominance of 61.5%. The most common diagnoses were stoma-related conditions (28.8%), rectal cancer (23.1%), and colon cancer (19.2%). Mechanical bowel preparation was administered to 63.5% of patients, and 82.7% received oral antibiotic prophylaxis. The vast majority (94.2%) underwent open surgery, with an average operative time of 150 minutes. Postoperative complications occurred in 26.9% of patients, and the mortality rate was 1.9%. The mean total length of hospital stay was 13.6 ± 6.5 days. And, the post operative hospital stay was 6.9days. Conclusion: This study highlights a mixed level of adherence to ERAS protocols in colorectal surgery. While basic safety measures and some prophylactic interventions are well established, there is a clear gap in implementing core ERAS principles such as early feeding, DVT prophylaxis, and minimally invasive techniques. These gaps may be contributing to prolonged hospital stays and elevated complication rates.
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    Assessment of Knowledge, Attitude, and Practice Regarding Enhanced Recovery After Surgery Colorectal Protocols Among Selected Healthcare Professionals at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia (2024)
    (Addis Ababa University, 2024-10-19) Megan Girma; Zelalem Assefa
    Background: Enhanced Recovery After Surgery (ERAS) colorectal protocol has demonstrated significant benefits in improving surgical outcomes and reducing complications. However, there is limited data on the awareness, attitude, and practice of ERAS among healthcare professionals in Ethiopia
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    Assessment of perioperative factors and postoperative outcomes associated with prolonged cardiopulmonary bypass duration in open heart surgery: a retrospective cross-sectional study, at TASH and CCE hospital in Addis Ababa, Ethiopia, 2025 G.C
    (Addis Ababa University, 2025-06) Jenberu,Yared; Negash,Ashanfi(MD, Cardiothoracic Fellow)
    Background: Cardiopulmonary bypass (CPB) plays a crucial role in numerous cardiac surgeries, enabling surgeons to conduct very complicated procedures by taking over the functions of the heart and lungs. Although CPB has transformed cardiac surgery, the duration of bypass is associated with a range of postoperative complications that can affect morbidity and mortality rates. While the duration of CPB is a known risk factor for morbidity and mortality after cardiac surgery, this relationship is also influenced other risk factors. Recognizing the implications of CPB duration is essential for improving surgical outcomes and ensuring patient safety. Objective: To investigate the association of cardiopulmonary bypass duration (CPB) on Perioperative factors and postoperative outcomes in patients undergoing open-heart surgery. Method: This study was a retrospective, cross-sectional study involving all elective patients undergoing open-heart surgery. Data collection was conducted through direct chart reviews. Key demographic parameters (Age, BMI & Sex), Clinical Comorbidities (LVEF, HTN, DM and CKD), Intraoperative factors (such as blood transfusion, CPB duration and hemofiltration), Postoperative outcome (length of stay in the intensive care, total hospital stays, duration of postoperative mechanical ventilation) were assessed. These data were collected using a systematically structured questionnaire. Data entry was performed using EPI Info version 4.7 software by the research team, and subsequently analysis was conducted in STATA. Descriptive statistics were conducted for both categorical and continuous variables. A chi-square test was employed to assess the association between the outcome variables and the independent variables. Those variables that demonstrate significance in the bivariate analysis was included in the multivariable analysis to evaluate the strength of the associations and identify statically variables. Result: According to a retrospective cross-sectional study carried out at the TASH and CCE hospitals in Addis Ababa, Ethiopia, adverse postoperative outcomes are substantially associated with prolonged cardiopulmonary bypass (CPB) duration (more than 120 minutes). According to the results, 38.36% of patients had prolonged CPB, and this condition was highly correlated with longer ICU hospitalizations—69.09% of patients who had ICU stays longer than 72 hours had prolonged CPB with p-value of 0.000. Furthermore, 55% of patients admitted for more than 10 days had prolonged CPB with p-value of 0.000 and 80.9% of patients who needed mechanical ventilation for 12 to 48 hours had prolonged CPB with p-value of 0.000.
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    Assessment Of Prevalence And Associated Factors Of Post Operative Acute Kidney Injury In Patients Who Underwent Open Heart Surgery In Addis Ababa, Ethiopia(2021 2024): A multicenter retrospective cross sectional study
    (Addis Ababa University, 2025-06) Getahun,Mahlet; Gulilat,Dereje(Ass.Prof.)
    Background Acute kidney injury (AKI) represents a significant complication following cardiac surgery, associated with increased morbidity and mortality rates adversely affecting patient outcomes. It is crucial to monitor the incidence of cardiac surgery-associated acute kidney injury (CSA-AKI). However, no prior study has been made in the context of the present study setting. Objectives: This study aimed to investigate the prevalence of cardiac surgery-associated acute kidney injury among adult cardiac surgery patients and its associated factors in cardiac surgery centers in Addis Ababa, Ethiopia. Methods: Institutional based cross-sectional retrospective study was conducted among 282 patients on systematic random sampling technique, focusing on both pediatric and adult patients who underwent open-heart surgery. Examining factors such as preoperative renal function, duration of cardiopulmonary bypass, intraoperative management, and postoperative renal function. The data was input into Epi data 4.7 and then transferred to STATA 17 for analysis. Associations between the outcome variable and independent variables were evaluated using a chi-square test. Variables showing significance in univariate analysis were analyzed in a multivariable model to assess the strength of associations and identify statistically significant factors. P value ≤ 0.05 of the statistical significance was used. The study took 5 months from January up to May was the study period. Result: Four of the variables were significant patients with DM have 3.44 times higher risk of developing AKI (AOR = 3.44, 95% CI; 1.43-9.09), age has a significant association with AKI, patients in over 60 years age group had 2.55 times higher risk odds of developing AKI (AOR = 2.55, 95% CI: 1.37-4.77), patients with ischemia periods greater than 90 minutes had 2.15 times the chance of having AKI (OR = 2.15, 95% CI: 1.10-4.22), Patients undergoing repeat operations had 4.20 times higher adjusted odds of developing AKI (AOR = 4.20, 95% CI: 1.25-14.10) compared to those having their first cardiac surgical procedure. Conclusion: The study revealed that a considerable number of DM, older age, longer aortic cross clamp time, redo surgery has significant association with AKI.