Thought on the Activities of the General Surgery Department of Aného Hospital (Togo): In Light of the New Policies for Decentralising Surgical Patients between 2023 and 2024

Abstract

Introduction/Aims: Begun in 2021, the creation of surgical departments according to surgical specialties was effective at the beginning of 2023, thus ending the era of the single large general surgery department bringing together all surgical patients at Aného hospital. What assessment and interpretation can be made from an administrative point of view of the activities specific to the general surgery department after this split? These are the questions which this work tries to find answers to. Materials and Methods : This was a retrospective and descriptive global study of the activities of the general surgery department from January 2023 to December 2024, i.e. over 24 months. The parameters studied were: the number of patients consulted, the main reasons for consultation, the number of patients hospitalised, the main causes of hospitalisation, the number of patients operated on and the performance indicators. Results: Over the two years, 1557 patients were consulted. In 2023 and 2024, the largest numbers of patients consulted were recorded respectively in August, 66 cases and in April, 269 cases. The main reasons for consultation were abdominal hernia tumefactions in 27.10% (n = 422); leg ulcers and infected wounds in 21.07% (n = 328) and abdominal pain in 19.14% (n = 298). In total 781 patients were hospitalised and 698 were operated on out of 1557, i.e. 50.16% and 44.83% respectively. Hernias were the main reason for hospitalisation, 342 cases i.e. 43.79% of hospitalised patients; peritonitis and appendicitis represented 4.74% (n = 37) and 3.84% (n = 30) respectively. Postoperative development was favorable in 98.69% (n = 303) and 98.10% (n = 465) of cases in 2023 and 2024 respectively. Mortality rates were 0.32% (n = 1) in 2023 and 0.42% (n = 2) in 2024 due to either septic shock or haemorrhagic shock. The evacuation rate of patients to other hospitals was 0.97% (n = 03) and 1.47% (n = 07) in 2023 and 2024 respectively. Bed occupancy and rotation rates were 22.41% and 2.40% in 2023 and 27.81% and 3.71% in 2024 respectively. Conclusion: The general surgery department, the mother surgical specialty, remains at the heart of the other surgical departments, with an assessment which does not betray the desire to always serve well from year to year. A subsequent accounting analysis of its activities will determine its financial weight in the Aného hospital budget and will enable us to support our various grievances to politicians.