Reasons For Cancellation of Elective Paediatric Surgery Cases

Abstract

Many factors have contributed to incessant cancellation of elective cases in paediatric surgery. The objective of this study was to review the reasons for cancellation of such cases in our centre and to suggest solutions to these problems. Prospective collation of information on all cancelled elective paediatric surgical cases was done. The bio-data on; clinical diagnosis and reasons for cancellation were documented. The study period was 18 months (March 2006- August 2007). Causes of cancellation were grouped into patients' factors (group A), parental factors (group B), and institutional factors (group C) There were 437 elective paediatric surgery cases within this period of which 298 (68.2%) were day cases and 139 (31.8%) were in-patients. Sixty-one patients (14%) were cancelled [36 (8.2%) day cases and 25 (5.8%) in-patients] of which 49 (80.3%) were males, 10 (16.4%) were females and 2 (3.3%) cases of ambiguous genitalia. The age ranged between 30 days and 11 years with a mean of 33.4 months ± SD of 34.4 months. The commonest reason for cancellation were in group A (22, 36.1%), followed by groups B and C (17or 27.9% each). The commonest reason in group A was Upper respiratory tract infection (59.1%), for group B was parents' refusal to present wards on the day of surgery (88.2%) and for group C was impromptu public holidays (58.8%). Elective paediatric surgery cases are usually cancelled in our centre due to Upper Respiratory Tract Infection (URTI) in children and parents' refusal to present their wards on surgery day. There is a need to properly review children with runny nostrils before cancellation because some children's nostrils are chronically wet and it may be delicate to postpone their operation. Adequate counseling of parents will reduce default. Keywords:  cancellation, elective, day-case, paediatric surgery