Daniyal A Khan1, Ayesha Farooq1,2, Uswa Jiwani1, Muhammad Asif Ahsan1, Farooq Shahzad3, Mohammad Fazlur Rahman1. 1. Department of Surgery, Aga Khan University, Karachi, Pakistan. 2. Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA. 3. Ann & Robert H. Lurie Children's Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Abstract
INTRODUCTION: Cleft palate repair is considered to be a safe procedure, yet still carries a 5% to 30% risk of complications. This study sought to assess the outcomes of this procedure in a high-burden Asian country that partners with the Smile Train to perform cleft surgeries. METHODS: The Aga Khan University medical records database was queried for pediatric patients undergoing cleft surgery between 2014 and 2017. Data were abstracted from the patient medical records, and details of the clinical, demographic factors, and postoperative outcomes were assessed. RESULTS: Among 142 patients with orofacial clefts, 102 (72%) underwent primary cleft palate repair, one-third (n = 36, 35%) of whom were operated as part of the Smile Train. The median preoperative hemoglobin was 11.4 g/dL (interquartile range: 10.7-12.0 g/dL), whereas the median weight was 8.3 kg (7.7-11.4 kg). Nearly two-thirds (n = 64, 63%) of the cohort underwent preoperative cardiology screening, with only a minority undergoing orthodontic treatment (n = 6, 6%). Approximately 15% (n = 15) of patients experienced a postoperative complication, most often a fistula (n = 11, 73%). On multivariable analysis, with each unit increase in hemoglobin levels, there was a 50% reduction in the odds of experiencing a complication (odds ratio: 0.51, 95% CI: 0.28-0.87). There were no in-patient deaths among the cohort. CONCLUSION: The results of the current study provide useful information to key stakeholders including patients, plastic surgeons, and policy makers on the outcomes of cleft palate repair in a developing country.
INTRODUCTION: Cleft palate repair is considered to be a safe procedure, yet still carries a 5% to 30% risk of complications. This study sought to assess the outcomes of this procedure in a high-burden Asian country that partners with the Smile Train to perform cleft surgeries. METHODS: The Aga Khan University medical records database was queried for pediatric patients undergoing cleft surgery between 2014 and 2017. Data were abstracted from the patient medical records, and details of the clinical, demographic factors, and postoperative outcomes were assessed. RESULTS: Among 142 patients with orofacial clefts, 102 (72%) underwent primary cleft palate repair, one-third (n = 36, 35%) of whom were operated as part of the Smile Train. The median preoperative hemoglobin was 11.4 g/dL (interquartile range: 10.7-12.0 g/dL), whereas the median weight was 8.3 kg (7.7-11.4 kg). Nearly two-thirds (n = 64, 63%) of the cohort underwent preoperative cardiology screening, with only a minority undergoing orthodontic treatment (n = 6, 6%). Approximately 15% (n = 15) of patients experienced a postoperative complication, most often a fistula (n = 11, 73%). On multivariable analysis, with each unit increase in hemoglobin levels, there was a 50% reduction in the odds of experiencing a complication (odds ratio: 0.51, 95% CI: 0.28-0.87). There were no in-patient deaths among the cohort. CONCLUSION: The results of the current study provide useful information to key stakeholders including patients, plastic surgeons, and policy makers on the outcomes of cleft palate repair in a developing country.
Authors: Man Yee Paula Tang; Sik Yin Nicholas Chao; Wai Yip Michael Leung; Kam Wing Kelvin Liu; Po Gee Geneviere Fung; Hin Biu Chan Journal: J Craniofac Surg Date: 2016-01 Impact factor: 1.046
Authors: Mohammed Mehboob Elahi; Ian T Jackson; Omar Elahi; Ayesha H Khan; Fatima Mubarak; Gul Bano Tariq; Amit Mitra Journal: Plast Reconstr Surg Date: 2004-05 Impact factor: 4.730
Authors: Adil Haider; John W Scott; Colin D Gause; Mira Meheš; Grace Hsiung; Albulena Prelvukaj; Dana Yanocha; Lauren M Baumann; Faheem Ahmed; Na'eem Ahmed; Sara Anderson; Herve Angate; Lisa Arfaa; Horacio Asbun; Tigistu Ashengo; Kisembo Asuman; Ruben Ayala; Stephen Bickler; Saul Billingsley; Peter Bird; Matthijs Botman; Marilyn Butler; Jo Buyske; Angelo Capozzi; Kathleen Casey; Charles Clayton; James Cobey; Michael Cotton; Dan Deckelbaum; Miliard Derbew; Catherine deVries; Jeanne Dillner; Max Downham; Natalie Draisin; David Echinard; Sohier Elneil; Ahmed ElSayed; Abigail Estelle; Allen Finley; Erica Frenkel; Philip K Frykman; Florin Gheorghe; Julian Gore-Booth; Richard Henker; Jaymie Henry; Orion Henry; Laura Hoemeke; David Hoffman; Iko Ibanga; Eric V Jackson; Pankaj Jani; Walter Johnson; Andrew Jones; Zeina Kassem; Asuman Kisembo; Abbey Kocan; Sanjay Krishnaswami; Robert Lane; Asad Latif; Barbara Levy; Dimitrios Linos; Peter Linz; Louis A Listwa; Declan Magee; Emmanuel Makasa; Michael L Marin; Claude Martin; Kelly McQueen; Jamie Morgan; Richard Moser; Robert Neighbor; William M Novick; Stephen Ogendo; Akinyinka Omigbodun; Bisola Onajin-Obembe; Neil Parsan; Beverly K Philip; Raymond Price; Shahnawaz Rasheed; Marjorie Ratel; Cheri Reynolds; Steven M Roser; Jackie Rowles; Lubna Samad; John Sampson; Harshadkumar Sanghvi; Marchelle L Sellers; David Sigalet; Bruce C Steffes; Erin Stieber; Mamta Swaroop; John Tarpley; Asha Varghese; Julie Varughese; Richard Wagner; Benjamin Warf; Neil Wetzig; Susan Williamson; Joshua Wood; Anne Zeidan; Lewis Zirkle; Brendan Allen; Fizan Abdullah Journal: World J Surg Date: 2017-10 Impact factor: 3.352
Authors: Thom C C Hendriks; Matthijs Botman; Charissa N S Rahmee; Johannes C F Ket; Margriet G Mullender; Barend Gerretsen; Emanuel Q Nuwass; Klaas W Marck; Henri A H Winters Journal: BMJ Glob Health Date: 2019-04-03