Re-Operations: A Two Year Experience at Gezira National Centre for Pediatric Surgery-Sudan

  • Abdalla Idris.A Faculty of medicine, university of Kordofan, assistant professor.
  • Faisal.A. Nugud Faculty of medicine, university of Gezera, professor of pediatric surgery.
  • Omer. A.M. Aboaaglla Pediatric surgeon Gezera State Minstary of Health.


Background: The development of pediatric surgical care in Africa has suffered from the neglecance of health policy makers, yet surgery remains an essential component of basic healthcare and an important means of providing preventive and curative treatment. Although the Sudan started with very few specialists who were trained in pediatric surgery to overcome the need of this specialty which started in the late of 70th and early of 1980th with only 5 surgeons.Re-operative surgery in pediatric patients is a challenge that is confronted by every surgeon, a particular operation may be initially done and followed by appropriate post-operative care, functional or anatomical problem may need further surgical intervention.

Objective:  To evaluate the magnitude of re-operation in pediatric patients seen at GNCPS.

Methods: This is a retrospective and prospective descriptive hospital based study that was conducted over two years as from March 2014 to Feb2016 at GNCPS. The study includes all pediatric surgical patients who needed a redo surgery. 

Result: The number of patients studied were111.The age distribution of studied group, the most common age group was less than 5year( n= 78) patients representing 70.3 %, followed by age group 6-10 year (n=19) 17.1% and the last age group 11-15(n=14) 12.6%. The ratio of male to female is 5.16:1. 61.3 %( n=68) of patients from the rural areas while 38.7% (n=32) from urban areas. The person who did the first operation: 47.7% (n=53) were done by pediatric surgeons, 28.8% (n=32) operated by registrars 18% (n=20) done by medical officers, 5.4% (n=6) operated by general surgeons. The final outcome of the patients: 49.5% (n=55) of them were alive without complications 35.1% (n=39) alive with complications, Number of patients who died were 15.3% (n=17).

Conclusion: The majority of redo-operations are done under the age of 5year. Less than 50% of the initial operations were done by specialized pediatric surgeons reflecting the gross shortage of surgeons in this discipline. More than 80% of initial operations were done at specialized centers reflecting the poor set-up at the center. The gastrointestinal (GIT) system was associated with the most surgical redo. The mortality following redo-operations was high.


1. Adeyemi SD. Newborn surgery under local anaesthesia. Prog Pediatr Surg 1982; 15:13-23.
2. Ameh EA, Ameh N. Providing safe surgery for neonates in sub-Saharan Africa. Trop Doct 2003; 33(3):145-7.
3. Benedict C. Nwomeh, MD1 and Philip M. Mshelbwala, FWACS, Paediatric Surgical Specialty: How Relevant to Africa? African Journal of Paediatric Surgery 2004; 1 (1):36-42
4. Harouchi A. [Have the advances of modern pediatric surgery reached the African children?]. Chir Pediatr 1990; 31(4-5):284-6.
5. Schweizera P, Bergerc S, , Schweizera M, et al. Repeated pull-through surgery for complicated Hirschsprung’s Disease—principles derived from clinical experience J Pediatr Surg. 42,536–543,2007.
6. Sarioglu A, Cahit Tanyel F, Buyukpamukcu N, et al. Redo operations of Hirschsprung’s disease. Int Surg. 83:333-335,1998.
7. Steven Teich, md Donna A. Caniano, md Reoperative Pediatric Surgery 2008 Humana Press, ISBN: 978-1-58829-761-7
8. Harsha WJ, Perkins JA, Lewis CW, Manning SC. Head and neck endocrine surgery in children: 1997 and 2000. Arch Otolaryngol Head Neck Surg 2005;131(7):564–570.
9. Skinner MA. Surgical diseases of the thyroid and parathyroid glands. In: Oldham KT, Colombani PM, Foglia RP, Skinner MA, (ed.), Principles and practice of pediatric surgery, volume 1. Philadelphia: Lippincott; 2005.
10. Machens A, Hinze R, Thomusch O, Dralle H. Pattern of nodal metastasis for primary and reoperative thyroid cancer. World J Surg 2002;26(1):22–28.
11. Iacobone M, Lumachi F, Favia G. Up-to-date on parathyroid carcinoma: analysis of an experience of 19 cases. J Surg Oncol 2004;88(4):223–228.
12. Witteles RM, Straus FH, Rao Koka ML, Kaplan EL. Parathyroid carcinoma. In: Randolph GW, (ed.), Surgery of the thyroid and parathyroid glands. Philadelpha: Saunders; 2003: 578–589.
13. Fokin AA, Robicsek F. Acquired deformities of the anterior chest wall. Thorac Cardiovasc Surg 2006;54:57–61.
14. Langham MR Jr, Kays DW, Ledbetter DJ, Frentzen B, Sanford LL, Richards DS. Congenital diaphragmatic hernia. Epidemiology and outcome. Clin Perinatol 1996;23(4):671–688.
15. Torfs CP, Curry CJ, Bateson TF, Honore LH. A population-based study of congenital diaphragmatic hernia. Teratology 1992;46(6):555–565.
16. Jeune M, Carron R, Beraud C, Loaec Y. Polychondrodystrophie avec Blcage Thoracique d’ Evolution fatale. Pediatrie 1954;9:390–392.
17. Jeune M, Beraud C, Carron R. Dystrophie thoracique asphyxiante de caractere familial. Arch Fr Pediatr 1955;12:886–891.
How to Cite
IDRIS.A, Abdalla; NUGUD, Faisal.A.; ABOAAGLLA, Omer. A.M.. Re-Operations: A Two Year Experience at Gezira National Centre for Pediatric Surgery-Sudan. Gezira Journal of Health Sciences, [S.l.], v. 13, n. 1, june 2017. ISSN 1810-5386. Available at: <>. Date accessed: 21 feb. 2019.