Original Research

Surgical outcomes in eastern Uganda: a one-year cohort study

A. Hewitt-Smith, F. Bulamba, C. Olupot, F. Musana, J.P. Ochieng, M.S. Lipnick, R.M. Pearse
Southern African Journal of Anaesthesia and Analgesia | Vol 24, No 5 | a1112 | DOI: https://doi.org/10.1080/22201181.2018.1517476 | © 2018 A. Hewitt-Smith, F. Bulamba, C. Olupot, F. Musana, J.P. Ochieng, M.S. Lipnick, R.M. Pearse | This work is licensed under CC Attribution 4.0
Submitted: 18 November 2025 | Published: 30 October 2018

About the author(s)

A. Hewitt-Smith, Faculty of Health Sciences, Busitema University, Mbale, Uganda
F. Bulamba, Faculty of Health Sciences, Busitema University, Mbale, Uganda
C. Olupot, Mbale Regional Referral Hospital, Mbale, Uganda
F. Musana, Faculty of Health Sciences, Busitema University, Mbale, Uganda
J.P. Ochieng, Faculty of Health Sciences, Busitema University, Mbale, Uganda
M.S. Lipnick, Department of Anesthesia and Perioperative Care, University of California, San Francisco, United States
R.M. Pearse, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom

Full Text:

PDF (491KB)

Abstract

Introduction: There is urgent need to improve access to safe surgical treatments for patients in low- and middle-income countries (LMICs). However, few data exist to characterise clinical outcomes for this patient population.
Methods: Consecutive patients undergoing surgery at a referral hospital in Uganda were prospectively followed between October 2016 and October 2017. The primary outcome was in-hospital, postoperative mortality. Secondary outcomes were in-hospital complications for patients undergoing laparotomy and Caesarean section. Results are presented as n (%) or odds ratios (OR) with 95% confidence intervals.
Results: A total of 4 773 patients of mean age 28 years were included; 3 754 were female (79.0%) and 4 259 patients (89.4%) were classified as American Society of Anesthesiologists class I or II. Some 3 501 (73.8%) procedures were performed on an emergency basis. The most frequent procedure was Caesarean section (2 634 patients [55.3%]). There were 93 deaths (2.0%), 49 of which occurred after the day of surgery (59.0%). In multivariable analysis, patients undergoing general (abdominal) surgery were at greatest risk of death (OR 4.34 [2.02–9.30]). Postoperative complications were recorded for 24/412 (5.8%) patients undergoing Caesarean section and 18/107 (16.8%) patients undergoing emergency laparotomy. Infection was the most frequent complication in these patient groups (33/519 patients [6.4%]).
Conclusions: This study confirms the feasibility of longitudinal audit of postoperative outcomes in LMICs. Data collected over a one-year period were highly consistent with the findings of a recent seven-day cohort study conducted across Africa.

Keywords

anaesthesia outcomes; global surgery; low-income country; postoperative care; surgical outcomes

Metrics

Total abstract views: 171
Total article views: 42

 

Crossref Citations

1. Postoperative mortality in Africa: are there any improvements in the last decade?
Wireko A. Awuah, Jyi Cheng Ng, Abubakar Nazir, Pearl O. Tenkorang, Rohan Yarlagadda, Jacob Kalmanovich, Toufik Abdul-Rahman, Aymar Akilimali, Vladyslav Sikora, Arda Isik
International Journal of Surgery  vol: 109  issue: 5  first page: 1080  year: 2023  
doi: 10.1097/JS9.0000000000000125

2. Implementation of a Surgical Critical Care Service Reduces Failure to Rescue in Emergency Gastrointestinal Surgery in Rural Kenya
Heath R. Many, Kemunto Otoki, Andrea S. Parker, Robert K. Parker
Annals of Surgery  vol: 277  issue: 3  first page: e719  year: 2023  
doi: 10.1097/SLA.0000000000005215

3. Euthyroidectomy under local versus general anesthesia in health camp settings in Uganda: a protocol for randomized prospective equivalence single-blind controlled trial
Umaru Kabuye, Jane Odubu Fualal, Herman Lule
Trials  vol: 24  issue: 1  year: 2023  
doi: 10.1186/s13063-023-07387-w

4. Gender Disparities in Complications, Costs, and Mortality After Emergency Gastrointestinal Surgery in Kenya
Kemunto Otoki, Andrea S. Parker, Heath R. Many, Robert K. Parker
Journal of Surgical Research  vol: 295  first page: 846  year: 2024  
doi: 10.1016/j.jss.2023.06.050

5. Incidence and predictors of perioperative mortality in a low-resource country, Ethiopia: a prospective follow-up study
Amanuel Sisay Endeshaw, Fantahun Tarekegn Kumie, Misganew Terefe Molla, Gashaw Abebe Zeru, Kassaw Moges Abera, Zebenay Bitew Zeleke, Tigist Jegnaw Lakew
BMJ Open  vol: 13  issue: 5  first page: e069768  year: 2023  
doi: 10.1136/bmjopen-2022-069768

6. Colombian surgical outcomes study insights on perioperative mortality rate, a main indicator of the lancet commission on global surgery – a prospective cohort study
Carlos J. Pérez Rivera, Nicolás Lozano-Suárez, Alejandro Velandia-Sánchez, Maria Paula Vargas-Cuellar, Luisa Fernanda Rojas-Serrano, Camilo A. Polanía-Sandoval, Daniela Lara-Espinosa, Laura García-Zambrano, Maria Paz Bohórquez-Tarazona, Silvia Valentina Agudelo-Mendoza, Paulo A. Cabrera-Rivera, Leonardo Briceno-Ayala, Carlos J. Pérez Rivera, Nicolás Lozano-Suárez, Silvia Valentina Agudelo-Mendoza, Maria Paz Bohórquez-Tarazona, Laura García-Zambrano, Daniela Lara-Espinosa, Camilo Andres Polania-Sandoval, Luisa Fernanda Rojas-Serrano, María Paula Vargas-Cuéllar, Alejandro Velandia-Sánchez, Paulo Andrés Cabrera-Rivera, Leonardo Briceno-Ayala, Danna Cruz-Reyes, Juan Guillermo Barrera Carvajal, Luis Felipe Cabrera-Vargas, Oscar Guevara, Laura Cristina Arce Polania, Laura Natalia Buendía Barrios, María Isabel Cristina Camargo Areyanes, Felipe Casas, Valeria Cormane Alfaro, Juan P. García-Méndez, Bayron Guerra, Sharon V. Idarraga-Ayala, Akram Kadamani Abiyomaa, Christopher Montoya, Manuel Santiago Mosquera Paz, María Alejandra Pineda, Juliana Pinzón-Luna, Isabella Roa Bastidas, Carlos Fernando Roman Ortega, Juan D. Saavedra Henao, Laura Carolina SanJuan-Arias, Vanessa Barreto, Julian Corso, Mariana Maksoud-Garcia, Eliana Pineda Mateus, Alejandra Vega Zabaraín, Fabien Mantilla-Sylvain, Nicolas Perez, Sergio Alzate-Ricaurte, Monica Bejarano, Isabella Caicedo Holguin, Alberto Federico García, Stefania Rodriguez Sanchez, Felipe Bernal Santos, Luis Felipe Cabrera-Vargas, Carlos Luna Jaspe, Maria Camila Luna-Jaspe Roa, Maria Paula OLIVERA Bolívar, MariaFernanda Valdivieso Diaz, Yuli Agudelo, Maria Paula Castillo-Aristizábal, Juan Pablo Hoyos Burgos, Maria Clara Maria Clara Mendoza Arango, Gabriel Arroyave, Felipe Buitrago Preciado, Lina María Cardona González, Juan Camilo Correa-Cote, Karen Lorena Franco Arias, Juan Felipe Llano Sierra, Gustavo López, Cesar Mancero, Sebastian Parra, Beatriz Ramirez Gonzalez, Daniela Sierra, Maria Camila Amaya Muñoz, Ashley Blanco-Ramírez, Paul Anthony Camacho, Jorge Campillo, Andrea Ximena Carvajal Mejia, María Alejandra González Yamil, Juan Carlos Osorno Villegas, Eduardo Rubio, Santiago Sánchez Herrera, Sebastian Sanchez Herrera, Tatiana Agudelo, Valentina Andrade, Laura Arango Pérez, Anibal Ariza-Gutiérrez, Jacobo Berrio, Natalia Cantillo Torres, Maria Valeria Chamorro-Rodríguez, Lucia Conde, Oscar Hernando Feo Lee, María Camila González Nieto, Laura Cecilia Ibañez-Pintor, Catalina Ochoa, Juan Ospina, Juan José Pérez-Ocampo, Esteban Portilla Rojas, Daniela Saaibi Rey, Eduardo Serrano, Sharon Michelle Solorza Velásquez, Angélica María Toro Cubides, Raúl Aguiar, Diego Armando Beltrán Rincón, Juan Sebastian Figueroa, Rafael Figueroa-Casanova, Maria Fernanda Gonzalez Mosos, Marcia Gabriela Gómez, Susana Osorno, Laura Laura Palacio, Jose Venegas, Liliana Marcela Caicedo Ramírez, Diana Catalina Cardona Gomez, Daniel Alejandro Fernandez Bolaños, Adriana Fernández-Diago, Victor David Olave Montaño, César Pastás, Silvia Marcela Amorocho, Jorge Barbosa-Santibañez, Vladimir Baron, Alejandra Cartagena-Alvarado, Maria Castillo, Maria Carolina Castillo-Florez, Omar David Dimian Mayorga, Elena Leonor Delgado-Nieto, Ernesto Fajardo, Omar Leonardo Gomez Polania, Tania Gonzalez, Daniel Felipe Guzman Mesa, Andres Isaza-Restrepo, Jaime A. Leal, Camilo Medina, Jorge Navarro-Alean, Maria Antonia Ocampo, Guillermo Oliveros, Maria Ortiz, Jorge I. Ortiz-Mahecha, Katherine Parra Abaunza, Felipe Antonio Pulido Reyes, Natalia Rivera-Rincón, Carlos Alfonso Rodriguez Pinedo, Lizeth Rodriguez Sanchez, Juan Javier Romero, Juan Carlos Sabogal Olarte, Javier Mauricio Salgado Tovar, Guillermo Andrés Torres, Linda Vallejo, Felipe Vargas-Barato, Ana María Vargas Patiño, Juan Pablo Villate León, Miguel Angel Montañez Aldana, Chiara Norato, Hugo Rojas Borda, Miguel Á Romero Núñez, Alejandro Sánchez, Jose Támara López, Jose Támara P, Wilmer Fernando Botache Capera, Rolando Medina Rojas, Juan Torres, Gina Catalina Trujillo, Gabriela Estefanía Cubillos Saavedra, Francisco García-Laverde, Jussef Camilo Naffah Enciso, Julian Arango Betancur, Adriana Cortés-Coronado, Susana Sepúlveda Tamayo, Valentina Arboleda Cardenas, Luis Guillermo García-Barrero, Jhonatan Enrique Garzón-Galindo, Lina Fernanda Torres Parada, Alejandro Arias Quintero, David Cano, Kevin Fernando Montoya Quintero, Santiago Nieto Muñoz, Paula Saza Mejía, Jesus David Gomez Barrios, María Angélica Jimeno, Ghandi Ignacio Restrepo Hernandez, Adrian Rodríguez-Sequea, Juan Carlos Varón Cotes, Hanner Enrique Acevedo Reyes, Claudia Marcela Barandica Bolaño, Maria Camila Sierra-Cote, Laura Daniela Angarita Vargas, Alix Yurany Báez Ramírez, Jose Armando Rodriguez Suarez, David Leonardo Sánchez, Silvia Natalia Sandoval Rangel, Edwin Ulloa Hurtado, Olga Esther Hernández Almanza, Rosalba Inmaculada Martínez Zubiria, Angel Alexis Muegues Salas, Diego Alexander Becerra Cardona, Fabio Hernán Cárdenas Santamaría, Juan Daniel Echeverri Castaño, Juan Sebastián Echeverri Uribe, María Helena Gaitán Buitrago, Luis Felipe Galvis Valencia, Andrea Henao Sabogal, David Felipe López Atehortúa, Juan Manuel Molina Uribe, Edwin Enrique Peñate Suárez, Heiller Torres Valencia, Marcela Velásquez Salazar, Catalina Correa, Hans García, Juan Hernández Leal, Paula Tatiana Muñoz Vargas, Dínimo José Bolívar Sáenz, Camilo Andrés Caicedo Medina, Camilo Andres Garcia Riaño, Stephanye Carrillo Gonzalez, Jaime Lorduy Gómez, Carlos Torres Madrid, Walter Torres Villa, Juan Sebastian Luengas Orozco, Camilo Avendaño Capriles, Carolina Diaz Blanco, Maria Lucía Brieva Hoyos, Paola Andrea Cantillo Moreno, Sofía Carolina Granados Mendoza, José Dario Vizcaino Lara, Karla Lizeth Babativa Peñuela, Paula Andrea Jiménez Bahamón, Jhonier Estiven Maldonado Rico, Duvan Ernesto Martínez Cortes, José Alfredo Orjuela Aragón, Lizeth Daniela Castro Roa, Julieth Sarmiento Gallego, Marta Maria Herazo Meza, Anlly Caterin Hernández Castillo, Rosa Gabriela Rojas Moncada, Lucia Fernanda Casanova Bermeo, Oscar Fernando Cortés Otero, Nicolás Diaz Pinilla, Harrison Rene Herrera Delgado, Simon Alberto Macías Segura, David Ramiro Muñoz Castrillón, Luis Ramiro Nuñez Romero, Cesar Andrés Polania Andrade, Hector Alejandro Valdez Toro, Ana María Cardozo Parrado, Jose Gonzalo Moros, Paula Andrea Nieto, Jorge Mario Patarroyo, Jose Luis Perilla Martínez, María del Pilar Torres Gutierrez, Erika Johana Benito Flórez, Mariana Vergel Gómez, Diana Ximena Robayo Rodriguez, Diego Fernando Salcedo Miranda, Maria Alejandra Triviño Cortés, William Baquero Sastre, Juan Sebastian Bonett, Eliana Cortes, Pedro Fernando Duque, Carlos Enrique Gutierrez, Piedad Echeverry, Andrés Felipe Motta Amar, Lorena Torres, Jeremias Carvajal Bautista, David Mauricio Figueroa Bohórquez, Manuel Latorre Quintana, Diego Fernando Olivera Briñez, Marcel Leonardo Quintero Contreras, Raúl Vera Gamboa, Mariana Arias Zapata, Cristhian Daniel Benavides Caipe, Luisa Fernanda Betancur Acevedo, Valentina Botero Zuluaga, Vanessa Figueroa-Espinoza, Arbey Leandro Londoño-Patiño, Santiago Moncayo-Gonzalez, Laura Sofia Puerta Suárez, Paula Camila Vargas-Arboleda, Lisbet Sofia Gonzalez Cera, Katerine Henao Toro, Leobardo de Jesus Ortiz Pino, Sergio Andrés Vasquez Vargas, Lency Naranjo Zuluaga, Jaime Chamorro Garzón, Adriana Paola Franco Rodriguez, Nataly Johana Acosta Alape, Andrés Felipe Arbelaez Mariño, Juan José Mora Herrera, Javier Felipe Ayala Muñoz, Yeiny Carina Camacho Pinzon, José Francisco Cárdenas Chacón, Liliana Andrea Peña Arenas, Gustavo Adolfo Rodriguez Camargo, Carlos Alberto Sánchez Arango, Daniel Mauricio Bolaños Ñañez, Diana Sofía Garcés-Palacios, María Alejandra Ñañez Pantoja, Omar Alejandro Ortega-Valencia, María Paula Gamboa Bernal, Juan David Lotero Gómez, Juan Sebastián Martínez-Gutiérrez, Daniel Morales-Gómez, Lina Pardo-Jiménez, Leon Miguel Fonseca Galindo, Angélica Maria Garcia Ramirez, Juan David Saurith Ramirez, Ivan Ricardo Barrero Montoya, Santiago Cadena Espitia, Salomé Pallares Rojas, Laura Camila Zapata Berrio, Diana Andrea Benavides Rodríguez, Juan Carlos Gonzalez, Sharon Valentina Idarraga, Óscar Eduardo Márquez Rodríguez, Ivi Yohana Marrugo Prieto, Laura Vanessa Soledad Machado, Manuel Latorre Quintana, Rubén Luna, Nicolás Navarro Pulido, Federico Javier Nuñez Ricardo, Andrea Elena García López, Fernando Girón Luque, Nasly Patiño Jaramillo, Néstor Fabian Pedraza Alonso, Javier Yecid Acuña Acuña Rivera JY, Oscar Alexander Guevara Cruz, Juan Sebastián Martínez Buitrago, Nathalia Montoya Oviedo, Marcia Roxana Santafe Guerrero, Juanita Carolina Chaves Cortés, Francisco Mauricio Rincón Tello, Diana Fernanda Bejarano Ramirez, Nicolas Andres Cortes Mejia, Camilo Ernesto Garzon Mesa, Alejandra Moncada Pabon, Diego Rymel Triviño Alvarez, Alonso Vera Torres, Maria Alejandra Cote Martinez, Juan Manuel Machado Rodriguez, Gonzalo Nuñez Martinez, Laura Naranjo Osuna, Andres Felipe Roldan Garay, Daniel Amado, Jaime Camacho-Mackenzie, Maria Ceballos Mora, Sara Cifuentes-Navarrete, Andrea Donoso-Samper, Manuel A. Ferro, Juan C. Gómez-Cáceres, Sebastián Gómez-Galán, Ana G. Leiva, Juan Lisarazo, Maria G. López-Castaño, Sofía Martínez-Gil, M.J. Montoya, Santiago Niño-Basto, Sergio Andrés Ortigoza-Espitia, Gustavo Páez, Jesús William Ramos-Anaya, María J. Rozo, Juan P. Umana, Andres Motta Amar, Andrés Felipe Barrera Vargas, Javier Dario Maldonado Escalante, German Ricardo Molina Marroquin, Silvia Alejandra Prada Lievano
The Lancet Regional Health - Americas  vol: 38  first page: 100862  year: 2024  
doi: 10.1016/j.lana.2024.100862

7. Inteligencia artificial en cirugía: creación y validación de una calculadora colombiana de riesgo de mortalidad perioperatoria
Nicolás Lozano-Suárez, Juan Felipe Salamanca-Lozano, Paulo Andrés Cabrera-Rivera, Leonardo Briceño-Ayala, Carlos J. Pérez-Rivera
Revista Colombiana de Cirugía  year: 2024  
doi: 10.30944/20117582.2741

8. Perioperative mortality in Colombia: perspectives of the fourth indicator in The Lancet Commission on Global Surgery – Colombian Surgical Outcomes Study (ColSOS) – a protocol for a multicentre prospective cohort study
Carlos J Pérez-Rivera, Nicolás Lozano-Suárez, Alejandro Velandia-Sánchez, Camilo A Polanía-Sandoval, Juan P García-Méndez, Sharon V Idarraga-Ayala, Julián M Corso-Ramírez, Danny Conde-Monroy, Danna L Cruz-Reyes, Carlos F Durán-Torres, Juan G Barrera-Carvajal, Luisa Fernanda Rojas-Serrano, Laura Alejandra Garcia-Zambrano, Silvia Valentina Agudelo-Mendoza, Leonardo Briceno-Ayala, Paulo A Cabrera-Rivera
BMJ Open  vol: 12  issue: 11  first page: e063182  year: 2022  
doi: 10.1136/bmjopen-2022-063182

9. Global neonatal perioperative mortality: A systematic review and meta-analysis
Leandro G. Braz, Jose Reinaldo C. Braz, Teofilo Augusto A. Tiradentes, Joao Vitor A. Soares, Jose E. Corrente, Norma Sueli P. Modolo, Paulo do Nascimento Junior, Mariana G. Braz
Journal of Clinical Anesthesia  vol: 94  first page: 111407  year: 2024  
doi: 10.1016/j.jclinane.2024.111407

10. Comparison of the PIPAS severity score tool and the QSOFA criteria for predicting in-hospital mortality of peritonitis in a tertiary hospital in Uganda: a prospective cohort study
Richard Newton Iranya, Ronald Mbiine, Andrew Weil Semulimi, Joan Nasige, Timothy Makumbi, Moses Galukande
BMC Surgery  vol: 22  issue: 1  year: 2022  
doi: 10.1186/s12893-022-01743-4

11. Perioperative outcomes of abdominal surgery in Ethiopia: a national clinical audit (2019–2024)
Atalel Fentahun Awedew, Fitsum Kifle Belachew, Megbar Dessalegn Mekonnen, Adugnaw Bogale Worku, Shamill Eanga Helill, Masresha Gebru Teklehaimanot, Kokeb Desita Belihu, Samrawit Tassew Mekuria, Fisiha Guade Tesifaw, Bethelhem Muluye, Kalkidan Kifle, Tesfay Yohannes Ambese, Amsalu Molla Getahun
Scientific Reports  vol: 16  issue: 1  year: 2025  
doi: 10.1038/s41598-025-30626-w

12. Nigerian surgical outcomes – Report of a 7-day prospective cohort study and external validation of the African surgical outcomes study surgical risk calculator
Babatunde Osinaike, Omobolaji Ayandipo, Tonia Onyeka, Olubusola Alagbe-Briggs, Alhassan Mohammed, Olanrewaju Oyedepo, Ahmed Nuhu, Felicia Asudo, Olanrewaju Akanmu, Chris Nwokorie, Abdulrahman Mohammed, Mark Edubio, Kodilinye Izuora, Rabiu Mohammed, Onochie Nweze, Michael Efu, Stella Eguma, Abiodun Jasper, Richard Ewah, Irene Akhideno, Chimaobi Nnaji, Suleiman Ado, Elizabeth Ogboli-Nwasor, Mamuda Atiku, Ibrahim Salisu, Yakubu Adinoyi, Edith Agu, Ibironke Desalu, Luka Samuel, Yunus Olorode, Oluwabunmi Fatungase, Olugbenga Akinwonmi, Folayemi Faponle, Olusola Idowu, Erdoo Isamade, Abdulrahman Aliyu, Shanka Buba, Garba Hamza, Bisola Onajin-Obembe, Simbo Amanor-Boadu
International Journal of Surgery  vol: 68  first page: 148  year: 2019  
doi: 10.1016/j.ijsu.2019.06.003

13. Perioperative Mortality Among Surgical Patients in a Low-Resource Setting
AU Ogbuanya, UU Nnadozie, VC Enemuo, RL Ewah, EO Boladuro, OM Owusi
Nigerian Journal of Clinical Practice  vol: 25  issue: 7  first page: 1004  year: 2022  
doi: 10.4103/njcp.njcp_1291_21

14. Thyroidectomy under local versus general anesthesia in health camp settings in Uganda: a randomized prospective equivalence single-blind controlled trial
Umaru Kabuye, Jane Odubu Fualal, Herman Lule
BMC Surgery  vol: 25  issue: 1  year: 2025  
doi: 10.1186/s12893-025-02810-2

15. Mortalidad perioperatoria en Tolima, perspectivas del cuarto indicador de The Lancet Commission on Global Surgery: un análisis preliminar de la cohorte prospectiva del estudio Colombian Surgical Outcomes Study (ColSOS)
Nicolás Lozano-Suárez, Camilo Andrés Polanía-Sandoval, Juan Pablo García-Méndez, Camilo Alejandro Velandia-Sánchez, Juan David Saavedra, Julián Miguel Corso-Ramírez, Leonardo Briceño-Ayala, Luis Felipe Cabrera, Paulo Andrés Cabrera-Rivera, Carlos J. Pérez-Rivera
Revista Colombiana de Cirugía  year: 2023  
doi: 10.30944/20117582.2289

16. Laparoscopic appendectomy improves outcomes and reduces costs in rural Kenya
Kemunto Otoki, Ian Simel, Daniel Moenga, Patricia Chesang, Robert K. Parker
Surgical Endoscopy  vol: 39  issue: 4  first page: 2191  year: 2025  
doi: 10.1007/s00464-025-11589-5

17. Family supplemented patient monitoring after surgery (SMARTER): a pilot stepped-wedge cluster-randomised trial
Adam Hewitt-Smith, Fred Bulamba, Akshaykumar Patel, Juliana Nanimambi, Lucy R. Adong, Bernard Emacu, Mary Kabaleta, Justine Khanyalano, Ayub H. Maiga, Charles Mugume, Joanitah Nakibuule, Loretta Nandyose, Martin Sejja, Winfred Weere, Timothy Stephens, Rupert M. Pearse
British Journal of Anaesthesia  vol: 133  issue: 4  first page: 846  year: 2024  
doi: 10.1016/j.bja.2024.06.027

18. Surgical Apgar score as a predictor of outcomes in patients following laparotomy at Mulago National Referral Hospital, Uganda: a prospective cohort study
Bruno Chan Onen, Andrew Weil Semulimi, Felix Bongomin, Ronald Olum, Gideon Kurigamba, Ronald Mbiine, Olivia Kituuka
BMC Surgery  vol: 22  issue: 1  year: 2022  
doi: 10.1186/s12893-022-01883-7