Around the world, 4.2 million people die every year within 30 days of undergoing surgery – with half of those deaths occurring in low- and middle-income countries, says a study in medical journal The Lancet.
There is also a significant unmet need for surgery in these countries.
Researchers at the universities of Cape Town (UCT) and Birmingham say that if all patients who needed operations had them, the number of global postoperative deaths would increase to 6.1 million a year.
They estimated that more people died each year within 30 days after surgery than from HIV, tuberculosis, and malaria combined (2.97 million).
The Lancet Commission on Global Surgery stated that 313-million surgical procedures were performed each year, but little was known about the quality of surgery globally, as robust postoperative death rates were available for only 29 countries.
"About 5-billion people globally are unable to have safe surgical treatment, and nearly 95% of these people live in low- and middle-income countries.
"Expanding surgical services to address unmet needs would add another 1.9 million postoperative deaths in these lower-income countries," said Bruce Biccard, professor and second chair of UCT's department of anaesthesia and perioperative medicine and president of the SA Society of Anaesthesiologists.
To avoid millions more people dying after surgery, planned expansion of access to surgery must be complemented by investment into improving the quality of surgery globally, he said.
Prof Dion Morton, Barling chair of surgery at Birmingham University and director of clinical research at the Royal College of Surgeons of England, concurred: "As efforts continue to increase access to surgery around the world, there is also an urgent need for research to improve the quality and safety of surgery."
