Post-operative complications following colorectal cancer surgery in Nigeria and Ghana: A systematic review.

Colorectal cancer is the third most common cancer worldwide. There is a rising incidence of colorectal cancer in low- and middle-income countries, including Nigeria and Ghana. Surgical treatment for colorectal cancer has demonstrated efficacy, albeit with a higher incidence of postoperative complications in low- and middle-income countries. This review aimed to explore the complications following surgery for colorectal cancer, in Nigeria and Ghana. This review was guided by the Cochrane Handbook for Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline. We searched Science Direct, MEDLINE, Embase, CINAHL, Scopus, and APA PsycINFO databases. All searches were conducted in August 2024. All study designs reporting surgical treatment of colorectal cancer within the past 10 years in Nigeria and Ghana were included. Four authors extracted the data, and a fifth author reviewed the data for accuracy and completeness. The Joanna Briggs Institute critical appraisal tools for cross-sectional, case series, and case-control studies were used for data quality assessment. A total of eleven studies with 6971 patients were included in this review. Males accounted for 57.1% of the patients and 42.9% were females. Study designs were mostly cross-sectional with sample sizes ranging from 2 to 4898. About half (50.7%) of the surgeries performed for colorectal cancer were hemicolectomies. A total of 530 postoperative complications were reported with the most reported as surgical site infection 27.5%. Other postoperative complications were death (21.7%), fascial/wound dehiscence (12.6%), bowel obstruction (11.1%), fistulae (10.6%), anastomotic leak (6.4%), bleeding (1.5%) and others (8.3%). There is a significant burden of postoperative complications following colorectal cancer surgery. The findings from this review suggest that there are key challenges with surgical treatment for colorectal cancer in the West African region that need to be addressed to improve the postoperative outcomes of patients.