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Clin Colon Rectal Surg 2022; 35(05): 410-416
DOI: 10.1055/s-0042-1746190
Review Article

Colorectal Surgery Practice, Training, and Research in Low-Resource Settings

Kathryn M. Chu
1   Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Francie van Zijl Drive Stellenbosch University, Tygerberg, South Africa
2   Department of Surgery, University of Botswana, Gaborone, Botswana
,
Lynn Bust
1   Centre for Global Surgery, Department of Global Health, Faculty of Medicine and Health Sciences, Francie van Zijl Drive Stellenbosch University, Tygerberg, South Africa
,
Tim Forgan
3   Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Francie van Zijl Drive Stellenbosch University, Tygerberg, South Africa
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Abstract

Colorectal surgery (CRS) practice, training, and research differ between low- and middle-income countries (LMICs) and high-income countries due to disparity in resources. LMIC CRS is primarily done by general surgeons due to the paucity of fully trained colorectal surgeons. The majority of colon and rectal resections are done using open techniques, and laparoscopy and robotic platforms are only available in select private or academic centers. Multi-disciplinary teams are not available in most hospitals, so surgeons must have a broad knowledge base, and learn to adapt their practice. Formal CRS training opportunities through accredited post-residency fellowships and professional colorectal surgical associations are limited in LMICs. CRS is less established as an academic field, and less data are generated in LMICs. There are fewer staff and less dedicated funding for CRS research. However, LMIC colorectal surgeons and researchers can contribute valuable clinical findings especially on conditions of higher prevalence in their settings such as anal squamous cell carcinoma and obstetric fistulas. Effective surgical care for colorectal conditions requires significant investment in infrastructure, training, and governance in LMICs. This is critical to improve access to safe surgical care for all.

Keywords

colorectal surgery - research - training - low- and middle-income countries


Publication History

Article published online:
13 September 2022

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