Trends and Outcomes of General Surgery in the Pakistani Population: A Retrospective Analysis

General Surgery in Pakistan: Trends and Outcomes

Authors

  • Waleed Ahmad Lahore Medical & Dental College (LM&DC), Lahore, Pakistan Author
  • Mustafa Khalid Waheed Lahore Medical & Dental College (LM&DC), Lahore, Pakistan Author
  • Saleha Nadeem Al-Aleem Medical College, Lahore, Pakistan Author
  • Muhammad Talha Lahore Medical & Dental College (LM&DC), Lahore, Pakistan Author
  • Amna Imran Al-Aleem Medical College, Lahore, Pakistan Author
  • Muhammad Ibrahim Tahir Lahore Medical & Dental College (LM&DC), Lahore, Pakistan Author

DOI:

https://doi.org/10.69750/dmls.02.01.090

Keywords:

General surgery, Pakistan, laparoscopic surgery, postoperative outcomes, surgical complications, healthcare disparities

Abstract

Background: General surgery in Pakistan addresses a broad spectrum of medical conditions. However, surgical outcomes in low- and middle-income countries (LMICs) are affected by resource limitations, disparities in healthcare access, and delayed presentations.

Objectives: This study aims to evaluate trends, outcomes, and predictors of complications in general surgery over a two-year period in a tertiary care center in Pakistan.

Methodology: A retrospective analysis was conducted on n=400 adult patients who underwent elective or emergency general surgical procedures from January 2022 to December 2024. Data on patient demographics, surgical approaches (open vs. laparoscopic), and postoperative outcomes were collected. Predictors of complications were analyzed using Chi-square tests, t-tests, and logistic regression.

Results: The mean age of patients was 44.5 (±12.8) years, with 58% being male. Laparoscopic techniques were used in 52% of surgeries, with a 6% conversion rate. Overall, 14% of patients experienced complications, including surgical site infections (5%) and hemorrhage (4%). Emergency procedures were associated with higher complication rates (p<0.01). Significant predictors of complications included BMI >30 kg/m² (OR: 2.3, 95% CI: 1.5–3.2, p<0.001), operative time >90 minutes (OR: 2.7, 95% CI: 1.8–4.1, p<0.001), and emergency surgery (OR: 3.2, 95% CI: 2.1–4.8, p<0.001). The 30-day mortality rate was 2%, predominantly due to emergency cases.

Conclusion: While laparoscopic techniques have improved surgical outcomes in Pakistan, disparities in emergency care and resource allocation persist. Addressing key predictors of complications through systemic reforms, enhanced training, and infrastructure improvements is crucial for aligning surgical outcomes with global standards.

Downloads

Download data is not yet available.

References

Chaudhry RM, Minhas S, Khan MA, Nargus S, Nawadat K, Khan MA, et al. COVID-19 testing trend: A retrospective analysis of the three major pandemic waves in Punjab, Pakistan. Cureus. 2024;16(1):e52309. doi:10.7759/cureus.52309

Balekouzou A, Yin P, Pamatika CM, Bishwajit G, Nambei SW, Djeintote M, et al. Epidemiology of breast cancer: retrospective study in the Central African Republic. BMC Public Health. 2016;16(1):1230. doi:10.1186/s12889-016-3863-6

Arnett DK, Blumenthal RS, Albert MA, Buroker AB, Goldberger ZD, Hahn EJ, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: executive summary. J Am Coll Cardiol. 2019;74(10):1376-1414. doi:10.1016/j.jacc.2019.03.009

Khalid IB, Sarwar A, Khalid HB, Sajjad B, Rehman B, Parvaiz MA. Clinicopathological features and treatment outcomes of male breast cancer in Pakistani population: A 10-year retrospective cross-sectional study. Breast Cancer (Auckl). 2024;18:11782234241233120. doi:10.1177/11782234241233120

Faisal F, Abrar A, Hassan NUR, Arshad H, Zameer I, Umar Imtiaz M, et al. Evaluating safety and efficiency of laparoscopic general surgery techniques in Pakistan: A retrospective study. Dev Med Life Sci. 2024;1(10):32-40. doi:10.69750/dmls.01.010.067

Ahmad R, Abbasi HJ, Nasir IUI, Shah MF. Demographic characteristics and short-term outcomes of laparoscopic colon cancer surgeries at a newly developed cancer center in Peshawar, Pakistan. Pak J Med Sci. 2024;40(5):918-921. doi:10.12669/pjms.40.5.8732

Abstract Journal General Surgery. ANZ J Surg. 2023;93(S1):56-83. doi:10.1111/ans.18401

Afzal A, Sheikh F, Zafar A, Tariq S, Iqbal S, Zafar U. Demographic and clinical characteristics of colorectal cancer patients: A retrospective analysis at a tertiary care hospital in Pakistan. Biol Clin Sci Res J. 2024;2024(1):814. doi:10.54112/bcsrj.v2024i1.814

Shah AA, Latif A, Zogg CK, Zafar SN, Riviello R, Halim MS, et al. Emergency general surgery in a low-middle income health care setting: Determinants of outcomes. Surgery. 2016;159(2):641-649. doi:10.1016/j.surg.2015.08.004

Amjad A, Imran A, Shahram N, Zakar R, Usman A, Zakar MZ, et al. Trends of caesarean section deliveries in Pakistan: Secondary data analysis from Demographic and Health Surveys, 1990–2018. BMC Pregnancy Childbirth. 2020;20(1):753. doi:10.1186/s12884-020-03457-y

Ranjha KU, Abid SF, Khan MH, Waheed MS, Sarfraz L, Kashif M, et al. Low middle income countries and academic productivity of neurosurgery: A quantitative analysis from Pakistan. J Clin Neurosci. 2025;132:110992. doi:10.1016/j.jocn.2024.110992

Khan MR, Bari H, Zafar SN, Raza SA. Impact of age on outcome after colorectal cancer surgery in the elderly – a developing country perspective. BMC Surg. 2011;11(1):17. doi:10.1186/1471-2482-11-17

Khan SA, Shallwani H, Shamim MS, Murtaza G, Enam SA, Qureshi RO, et al. Predictors of poor outcome of decompressive craniectomy in pediatric patients with severe traumatic brain injury: A retrospective single center study from Pakistan. Childs Nerv Syst. 2014;30(2):277-281. doi:10.1007/s00381-013-2225-2

Farooq MZ, Mahmood K, Zafar MA, Chatha SS, Saeed MF, Qureshi TM. A comparative study of minimal invasive and open colorectal surgeries with regards to postoperative hospital stay and complications. Pak Armed Forces Med J. 2022;72(1):319-322. doi:10.51253/pafmj.v72i1.6711

Hassanein AG. Trends and outcomes of management of mandibular fractures. J Craniofac Surg. 2019;30(4):1245-1251. doi:10.1097/scs.0000000000005469

Rahman S, Zheleva B, Cherian KM, Christenson JT, Doherty KE, de Ferranti D, et al. Linking World Bank development indicators and outcomes of congenital heart surgery in low-income and middle-income countries: Retrospective analysis of quality improvement data. BMJ Open. 2019;9(6):e028307. doi:10.1136/bmjopen-2018-028307

Dubal PM, Unsal AA, Chung SY, Patel AV, Park RCW, Baredes S, et al. Population-based trends in outcomes in adenoid cystic carcinoma of the oral cavity. Am J Otolaryngol. 2016;37(5):398-406. doi:10.1016/j.amjoto.2016.06.001

Qamar FN, Yousafzai MT, Sultana S, Baig A, Shakoor S, Hirani F, et al. A retrospective study of laboratory-based enteric fever surveillance, Pakistan, 2012–2014. J Infect Dis. 2018;218(suppl 4):S201-S205. doi:10.1093/infdis/jiy205

Silesh M, Lemma T, Fenta B, Biyazin T. Prevalence and trends of congenital anomalies among neonates at Jimma Medical Center, Jimma, Ethiopia: A three-year retrospective study. Pediatr Health Med Ther. 2021;12:61-67. doi:10.2147/PHMT.S293285

Wan S, Yang M, Pei J, Zhao X, Zhou C, Wu Y, et al. Pregnancy outcomes and associated factors for uterine rupture: An 8 years population-based retrospective study. BMC Pregnancy Childbirth. 2022;22(1):91. doi:10.1186/s12884-022-04415-6

Purcell LN, Robinson B, Msosa V, Gallaher J, Charles A. District general hospital surgical capacity and mortality trends in patients with acute abdomen in Malawi. World J Surg. 2020;44(7):2108-2115. doi:10.1007/s00268-020-05468-4

Downloads

Crossmark - Check for Updates PlumX Metrics

Published

31-01-2025

How to Cite

Ahmad, W., Waheed, M. K. ., Nadeem, S. ., Talha, M. ., Imran , A. ., & Tahir, M. I. . (2025). Trends and Outcomes of General Surgery in the Pakistani Population: A Retrospective Analysis: General Surgery in Pakistan: Trends and Outcomes. DEVELOPMENTAL MEDICO-LIFE-SCIENCES, 2(1), 13-17. https://doi.org/10.69750/dmls.02.01.090

Share