Pediatric Surgical Volume at the TASH: Experience after the Expansion of Pediatric Surgery Program.

Background: Ethiopia has a high unmet need for pediatric surgical conditions. Over the past 5 years, new changes have been introduced to the pediatric surgery division at Addis Ababa University to overcome this issue. The changes include initiation of pediatric surgery residency, allocating operating room for pediatric surgery, weekend surgical campaign and starting ultrasound guided hydrostatic reduction. We conducted this study to evaluate the pattern and outcome of pediatric surgical cases after these changes. Methods: The study was a retrospective review conducted at Tikur Anbessa Hospital from Jan - Dec 2019. Data was collected from duty report forms that included emergency procedures, admissions and mortalities. Data on elective procedures was collected from operation theater log books. Results: Overall, a total of 1590 pediatric surgical procedures were performed during 2019 of which 942 cases were elective and 648 were emergency. This was an increment in number of surgeries performed by 75%. The leading emergency procedure was aerodigestive foreign body removal which increased by 46%. Surgery for intussusception has decreased by 30% with increasing use of hydrostatic reduction. Overall, average morbidity and mortality was 3.5% and 6.9% respectively. Morbidity and mortality rates were similar throughout the year. Conclusion: The study shows increased productivity over the past year with the changes made in the department. There is also no increment in morbidity and mortality during the start of the academic year. This implies adequate consultant supervision of residents during transition.