Surgical epidemiology of Antarctic stations from 1904 to 2022: A scoping review

Figures & data

Table 1. Keywords used for search strategy.

Database	Pub Med	Google Scholar
Keywords	(antarctic [MeSH terms] AND surgery [MeSH terms]) OR (medicine [MeSH terms] AND antarctic [MeSH terms]) OR (epidemiology [MeSH terms] AND antarctic [MeSH terms]) OR (dental [MeSH terms] AND antarctica [MeSH terms]) OR (antarctic [MeSH terms] AND emergency [MeSH terms]) OR (telemedicine [MeSH terms] AND antarctic [MeSH terms]) OR (evacuation [MeSH terms] AND antarctica [MeSH terms]) OR (case report AND surgery [MeSH terms] AND Antarctica [MeSH terms]) OR (health care [MeSH terms] AND Antarctica [MeSH terms])	“Antarctic surgery” OR “Antarctic medicine” OR “Medicine in Antarctica” OR “Antarctic epidemiology” OR “Antarctic dental” OR “Antarctic telemedicine” OR “Antarctic evacuation” OR “Polar Surgery” OR “Polar medicine” OR “Polar epidemiology” OR “Antarctica health” OR “Antarctic anaesthesia” OR “Antarctic physician” OR “Emergency Antarctic” OR “Telemedicine in Antarctica”

Figure 1. Flowchart.

Figure 2. Antarctic stations cited in the publications classified by the Antarctic program corresponding to the period under study. For example, the Hope Bay station belonged to the British program in 1970 but was transferred to the Uruguayan program from 1997. Argentine Island station was transferred to the Ukraine on 6 Feb 1996 and renamed Vernadsky. Adelaid Island was transferred to Chile 14 Aug 1984 and renamed Teniente Luis Carvajal Villaroel Antarctic Base [2,44].

Figure 3. Time periods covered by the reviewed publications.

Table 2. List of surgical procedures or reasons for surgical consultation listed in the literature.

Surgical speciality	Surgical procedures or reason for consultation	Numbers of publications per item	General anaesthesia
Orthopedic	Incision & drainage of pus from ankle	n = 1 [11]
	Amputation (toes, big toe, not detailed)	n = 5 [12,13,19,27,41]	Partial amputation of the big toe [19], and other toes [41]
	Fractures (tibia/fibula, medial malleolus, limbs,facial bones, vertebrae, arm, thorax, pelvis,femor, mandible, wrist)	n = 9 [12–14,18,19,23,27,34,35]	Femoral fracture reduction [19]
	Dislocation	n = 2 [12,23]
	Animal bites	n = 2 [12,27]
	Nerve damage	n = 1 [12]
	Foreign bodies	n = 5 [12,27,30,31,35]
	Superficial and deep wound	n = 9 [10,12,15,27,30,31,33,35,41]	Foot repair with joint damage [41]
	Tendon injuries	n = 1 [12]
	Exostosis	n = 1 [13]
	Frostbite	n = 2 [13,27]
	Soft tissue infection	n = 1 [30]
	Nail trauma	n = 1 [30]
	Crushed member	n = 1 [27]
	Not detailed – unknown	n = 16 [6,12,13,18,21,22,25,26,29–33,35,38,43]
Digestive	Inguinal hernia	n = 2 [12,27]
	Hemorroids	n = 5 [12,27,30,31,35]
	Laparotomy & drainage	n = 2 [27,36]	[36]
	Gastrointestinal bleeding	n = 1 [36]
	Appendicitis	n = 15 [6,13,14,22–24,26,27,30–32,35,37,41,42]	[24,41,42]
	Bleeding duodenal ulcer or ulcerative colitis	n = 2 [27,38]
	Peritonitis	n = 1 [24]
	Not detailed – unknown	n = 16 [12,13,18,21,22,25–33,35,43]
General	Tumor removal	n = 1 [10]
	Polytrauma	n = 3 [14,22,26]
	Skin tumour	n = 2 [31,35]
	Sebaceous cyst	n = 1 [27]
	Breast tumour	n = 1 [27]
	Not detailed – unknown	n = 5 [21,22,28,33,43]
Eye surgery	Eye injuries due to foreign bodies	n = 5 [15,24,27,31,35]	For enucleation of an eye due to a foreign body [24]
	Eye injuries after blunt trauma	n = 3 [19,35,41]	For enucleation of a traumatic eye [41]
	Not detailed – unknown	n = 12 [6,12,18,21,22,28–31,33,35,43]
Urological	Urolithiasis	n = 3 [13,32,35]
	Vesicostomy	n = 2 [26,31]
	Not detailed – unknown	n = 7 [13,21,22,28,29,31,35]
ENT	Pharyngeal foreign bodies	n = 2 [31,35]
	Epistaxis	n = 1 [12]
	Facial trauma	n = 1 [27]
	Not detailed – unknown	n = 10 [21,22,28–33,35,43]
Neurosurgery	Intracranial haemorrhage due to aneurysm	n = 3 [13,24,40]	For craniotomy, aspiration [40]
	Subarachnoid haemorrhage due to cerebral aneurysm	n = 1 [27]
Thoracic	Chest drainage for bronchial occlusion after inhaling foreign body	n = 1 [39]
Dentistery	Dental fillings (caries)	n = 7 [11,14–16,27,31,35]
	Tooth restoration (fracture, amalgam)	n = 5 [16,17,20,31,35]
	Incision & drainage (abscesses)	n = 2 [16,27]
	Dental extraction	n = 4 [16,17,27,41]	[41]
	Light astringent treatment	n = 1 [17]
	Not detailed – unknown	n = 16 [12,13,18,21,22,25–33,35,43]

Table 3. List of MEDEVAC reasons for surgery in Antarctica and their destination from 1904 to 2018.

Surgical speciality	Pathologies	Reference number	Departure station	Arrival point
Orthopedic	Pelvic fracture	[18] [26]	Syowa JARE station	Japan NR
	Femur fracture	[18] [19]	Syowa Maitri	Japan India
	Polytrauma: one case of femur and cervical fracture, one case of pelvic fracture and ureter injury	[22]	Syowa	Japan
	Tibiofibular fracture	[13]	Casey OR Mawson OR Wilkes	NR
	Fracture of the medial malleolus	[13]	Casey OR Mawson OR Wilkes	NR
	Exostosis of humerus	[13]	Casey OR Mawson OR Wilkes	NR
	Facial and spinal trauma	[14]	Halley Bay	NR
	Unspecified trauma	[32] [38]	McMurdo ANARE station	NR NR
	Fall into a crevasse	[31]	JARE station	NR
Digestive	Gastrointestinal haemorrhage	[36]	Davis	Christchurch (New Zealand)
	Abdominal pain explored by laparotomy and drainage	[36]	Casey	Australia
	Appendicitis	[13] [26] [32]	Casey OR Mawson OR Wilkes McMurdo McMurdo	NR New Zealand NR
	Ulcerative colitis	[27]	Argentine Island	Argentina
Urological	Kidney stone	[13] [32]	Casey OR Mawson OR Wilkes Amundsen Scott	NR NR
	Cystoostomy on prostatic hypertrophy	[26]	Syowa	NR
ENT	Inhaled foreign body	[39]	Rothera	Montevideo (Uruguay)
Neurosurgery	Intracranial haemorrhage due to aneurysm	[13,24,40]	Mawson	Christchurch (New Zealand)
	Subarachnoid haemorrhage due to cerebral aneurysm	[27]	Halley Bay	London (United Kingdom)
Dental	Dental care	[11]	Novolazarevskaya	Maitri (Indian station)
Not detailed	No diagnosis	[13]	Casey OR Mawson OR Wilkes	NR

Note : JARE: Japanese Antarctic Research Expedition, ANARE: Australian National Antarctic Research Expedition, NR: Not Reporter, ENT: Ear, Nose, Throat.

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