Head and neck surgical subspecialty training in Africa: Sustainable models to improve cancer care in developing countries

被引:25
作者
Fagan, Johannes J. [1 ]
Zafereo, Mark [2 ]
Aswani, Joyce [3 ]
Netterville, James L. [4 ]
Koch, Wayne [5 ]
机构
[1] Univ Cape Town, Fac Hlth Sci, Div Otorhinolaryngol, ZA-7700 Rondebosch, South Africa
[2] Univ Texas MD Anderson Canc Ctr, Dept Head & Neck Surg, Houston, TX 77030 USA
[3] Univ Nairobi, Dept Surg, Coll Hlth Sci, Nairobi, Kenya
[4] Vanderbilt Bill Wilkerson Ctr, Dept Head & Neck Surg, Nashville, TN USA
[5] Johns Hopkins Head & Neck Canc Ctr, Dept Otolaryngol Head & Neck Surg, Baltimore, MD USA
来源
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2017年 / 39卷 / 03期
关键词
head and neck cancer; developing world; developing countries; Africa; surgery; training; fellowship; subspecialty; outreach; humanitarian; LARYNGECTOMY REHABILITATION INTERVENTIONS; RADIOTHERAPY RESOURCES; THYROID LOBECTOMY; PERSPECTIVE;
D O I
10.1002/hed.24591
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Background. Cancer poses a health crisis in the developing world where surgery is the mainstay of treatment for head and neck cancers. However, a shortage of surgeons with appropriate skills exists. How do we train head and neck surgeons in developing countries and avoid a brain drain? The ideal model provides appropriate affordable training leading to establishment of head and neck cancer centers that teach and train others. Methods. Different head and neck surgery training models are presented based on the personal experiences of the authors. Surgical exposure of head and neck fellows in Cape Town and (potentially) in Nairobi is benchmarked against programs in the United States. Results. Surgical exposure in Cape Town is equivalent to that in the United States, but more appropriate to a developing world setting. Conclusion. Training can be achieved in a number of ways, which may be complimentary. Fellowship training is possible in developing countries. (C) 2016 Wiley Periodicals, Inc.
引用
收藏
页码:605 / 611
页数:7
相关论文
共 12 条
[1]   Status of radiotherapy resources in Africa: an International Atomic Energy Agency analysis [J].
Abdel-Wahab, May ;
Bourque, Jean-Marc ;
Pynda, Yaroslav ;
Izewska, Joanna ;
Van der Merwe, Debbie ;
Zubizarreta, Eduardo ;
Rosenblatt, Eduardo .
LANCET ONCOLOGY, 2013, 14 (04) :E168-E175
[2]   International practice of laryngectomy rehabilitation interventions: a perspective from South Africa [J].
Fagan, Johan J. ;
Lentin, Roslyn ;
Quail, Gavin .
CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY, 2013, 21 (03) :199-204
[3]   Survey of ENT services in Africa: need for a comprehensive intervention [J].
Fagan, Johan J. ;
Jacobs, Marian .
GLOBAL HEALTH ACTION, 2009, 2 :1-7
[4]   Expansion of cancer care and control in countries of low and middle income: a call to action [J].
Farmer, Paul ;
Frenk, Julio ;
Knaul, Felicia M. ;
Shulman, Lawrence N. ;
Alleyne, George ;
Armstrong, Lance ;
Atun, Rifat ;
Blayney, Douglas ;
Chen, Lincoln ;
Feachem, Richard ;
Gospodarowicz, Mary ;
Gralow, Julie ;
Gupta, Sanjay ;
Langer, Ana ;
Lob-Levyt, Julian ;
Neal, Claire ;
Mbewu, Anthony ;
Mired, Dina ;
Piot, Peter ;
Reddy, K. Srinath ;
Sachs, Jeffrey D. ;
Sarhan, Mahmoud ;
Seffrin, John R. .
LANCET, 2010, 376 (9747) :1186-1193
[5]   Long-Term Outcomes of Total Thyroidectomy Versus Thyroid Lobectomy for Papillary Thyroid Microcarcinoma: Comparative Analysis After Propensity Score Matching [J].
Lee, Jandee ;
Park, Jae Hyun ;
Lee, Cho-Rok ;
Chung, Woong Youn ;
Park, Cheong Soo .
THYROID, 2013, 23 (11) :1408-1415
[6]   Thyroid lobectomy for treatment of well differentiated intrathyroid malignancy [J].
Nixon, Iain J. ;
Ganly, Ian ;
Patel, Snehal G. ;
Palmer, Frank L. ;
Whitcher, Monica M. ;
Tuttle, Robert M. ;
Shaha, Ashok ;
Shah, Jatin P. .
SURGERY, 2012, 151 (04) :571-579
[7]  
Onyango J F, 2006, East Afr Med J, V83, P85
[8]   Effect of cloth stoma covers on tracheal climate of laryngectomy patients [J].
Quail, Gavin ;
Fagan, Johannes J. ;
Raynham, Oliver ;
Krynauw, Hugo ;
John, Lester Ryan ;
Carrara, Henri .
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2016, 38 :E480-E487
[9]   Hypothyroidism after primary radiotherapy for head and neck squamous cell carcinoma: Normal tissue complication probability modeling with latent time correction [J].
Ronjom, Marianne Feen ;
Brink, Carsten ;
Bentzen, Soren M. ;
Hegedus, Laszlo ;
Overgaard, Jens ;
Johansen, Jorgen .
RADIOTHERAPY AND ONCOLOGY, 2013, 109 (02) :317-322
[10]   Quantitative status of resources for radiation therapy in Asia and Pacific region [J].
Tatsuzaki, H ;
Levin, CV .
RADIOTHERAPY AND ONCOLOGY, 2001, 60 (01) :81-89