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Surgical Science 2022年第12期13卷 585-591页

作者： Amara Coulibaly abdoul k.rim simaga Moussa Sissoko Sekou koumaré Mamedy Doumbia Sidiki konaré Zimogo Zie Sanogo Surgical Department “A” of the University Hospital Center (CHU) of Point-G Bamako Mali Surgical Department of the Centre Hospitalier Universitaire Mère-Enfant (CHU-ME) le “Luxembourg” Bamako Mali

Introduction: Laparoscopic cholecystectomy is a surgical technique that involves the removal of the gallbladder by laparoscopy. Its practice is timid in sub-Saharan Africa, despite the existence of risk factors such as sickle cell disease. We report our 2-year experience of laparoscopic cholecystectomy in the general surgery department of the CHU-ME Luxembourg. Materials and Method: This was a descriptive cross-sectional study from September 2019 to September 2021. The study included 64 patients with vesicular lithiasis who underwent laparoscopic cholecystectomy. Data were analyzed on SPSS software (version 25.0). Confidentiality and anonymity of the subjects were respected. Results: The frequency of cholecystectomy was 30.9%. The average age was 38.37 ± 16.94 years. The female sex was 70.3%. Obesity and sickle cell disease were found in 85.9% and 14.1% of patients. On physical examination, hepatic colic was found in 54.7% and the Murphy sign was positive in 64.1% of patients. Ultrasound diagnosis of vesicular lithiasis was made in all patients. All patients underwent laparoscopic cholecystectomy, which was retrograde in 64.1% of cases. The average procedure time was 66 minutes. No case of complication was recorded postoperatively. Conclusion: Laparoscopic cholecystectomy is a technique to be developed and supported.

关键词： Cholecystectomy Laparoscopic Lithiasis Mali

Review of Laparoscopic Activities at the University Hospital Center (CHU) “Mère-Enfant Luxembourg” in 100 Cases

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Surgical Science 2023年第2期14卷 143-150页

作者： Amara Coulibaly Moussa Sissoko Sidiki konaré abdoul k.rim simaga Sekou koumaré Drissa k. Bagayoko Cheichna Tounkara Zimogo Zié Sanogo Surgical Department “A” of The University Hospital Center (CHU) of Point-G Bamako Mali Surgical Department of The Centre Hospitalier Universitaire Mère-Enfant (CHU-ME) le “Luxembourg” Bamoko Mali

Introduction: Laparoscopic surgery is a surgical technique that allows to intervene under the control of an endoscope, introduced into the abdominal cavity previously distended by an artificial pneumoperitoneum. We propose in this study to bring the assessment of the laparoscopic activities in the department of general surgery at the CHU MERE-ENFANT “Luxembourg”. Methodology: This was a descriptive cross-sectional study from September 2019 to September 2020 including 100 cases of laparoscopic procedures at the University Hospital Mother and Child “Luxembourg”. All patients regardless of pathology, who underwent laparoscopic surgery with or without conversion to conventional surgery were included in the study. The data were collected from routine media such as the consultation register and the operative report register. Data analysis was performed using SPSS 21 software. Informed consent was obtained from the patients before their inclusion in the study, and each patient was assigned an anonymity number. Results: In our study, the female sex represented of the patients, i.e. 76% with a sex ratio of 3.2. Housewives were 53% of the cases. The majority of patients were in the age range of 16 - 30 in 44% of cases and 75% were married. Overweight/obesity, hypertension and peptic ulcer were the main medical histories with 22%, 12% and 10% respectively. All patients presented with abdominal pain. Cholecystectomy was the main activity during the study with a frequency of 43%, followed by tube surgery and appendectomy. The average duration was 53 minutes for digestive pathologies 48 minutes with extremes of 22 and 66 minutes for gynecological pathologies. One case of injury to the cystic artery was recorded. The conversion rate was 6% of cases. We recorded 5 cases of suppuration as a postoperative complication. The length of stay was 2 - 3 days in 96% of patients. Conclusion: In view of this study, the feasibility of laparoscopic surgery at the CHU Mère Enfant “Luxembourg” is

关键词： Laparoscopic Surgery Assessment Mali

Appendicular Mucocele: About a Case Observed in Bamako

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Surgical Science 2022年第12期13卷 577-584页

作者： Amara Coulibaly abdoul k.rim simaga Moussa Sissoko Sekou koumare Sidiki konare Mamedy Doumbia Zimogo Zié Sanogo Department of Surgery “A” of the University Hospital Center (CHU) of Point-G Bamako Mali Surgery Department of the Mother-Child University Hospital Center (CHU-ME) “Luxembourg” Bamako Mali

It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.

关键词： Appendicular Mucocele Appendicular Tumor Bamako

Results of Combined Chemotherapy and External Beam Radiotherapy for Unilateral Intra-Orbital Retinoblastoma—A Multi-Institutional Study from Mali

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Open Journal of Pediatrics 2019年第1期9卷 39-46页

作者： Boubacar Togo Fousseyni Traore konimba Diabate Fatou Sylla Aichata Tall Affiatou simaga Bakarou kamate Hawa Diall Pierre Togo abdoul k.rim Doumbia Pierre Bey Francis Eshun Department of Pediatrics Gabriel Toure HospitalBamakoMali Radiation Therapy Service National Hospital of MaliBamakoMali Institute of Tropical Ophthalmology of Africa(IOTA) BamakoMali Department of Histopathology Hospital of Point GBamakoMali Curie Institute et AMCC ParisFrance Phoenix Children’s Hospital PhoenixAZUSA

Retinoblastoma (RB) treatment aims at saving the life and preserving useful vision. In most low-income countries, because of delays in diagnosis, advanced disease presentation is quite common. This prospective study aimed at evaluating the treatment results of orbital RB with regards to overall survival rate of the patients treated with chemotherapy and radiotherapy. The study was performed from 01 November 2011 to 31 December 2015 in the paediatric oncology unit of Gabriel Touré Teaching Hospital, Bamako, Mali and The Institute of Tropical Ophthalmology of Africa (IOTA), Bamako, Mali. All intra-orbital non-metastatic RB cases not previously treated by chemotherapy or radiotherapy were included in this study. Fourteen patients were included into the study. Median age was 2 years, and sex ratio 2.5 (M = 10;F = 4). Right eye (n = 12, 85.7%) was more often affected than left eye (n = 2;14.3%). Chemotherapy toxicities were mainly haematological including grade 3 anemia (n = 2;7%) and grade 4 neutropenia (n = 3;11%). Twelve patients (86%) were enucleated after neoadjuvant chemotherapy. Two patients (14%) abandoned treatment before enucleation. The IRSS pathology staging was: stage IIIa in 6 patients (50%), and stage II in six patients (50%). Six children (43%) received orbital radiotherapy at total dose of 45 Gy;Six children (43%) achieved complete remission;Overall survival rate was 48% at 4 years (95% CI: 22.5% - 74.4%). In conclusion, the therapeutic strategy based on neoadjuvant chemotherapy followed by enucleation, adjuvant chemotherapy and external beam radiotherapy, was beneficial in patients with stage III disease, achieving an event-free survival rate of 48%.

关键词： Orbital Retinoblastoma Children Mali

Management of Acute Myeloblastic Leukaemia (AML) Treated with Intensive Chemotherapy: Experience in a Single Centre

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Open Journal of Pediatrics 2024年第2期14卷 401-411页

作者： abdoul k.rim Doumbia Hawa konaré Tati simaga Pierre Togo Oumoulkairi Nana kouma Hawa Gouro Diall Oumar Coulibaly Adama Dembélé Mohamed Elmouloud Cissé karamoko Sacko Belco Maiga Aminata Doumbia kalirou Traoré Ibrahima Cissé Boury Traoré abdoul Aziz Diakité Fousseyni Traoré Boubacar Togo Department of Pediatrics University Hospital Gabriel Touré Bamako Mali

Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.

关键词： Acute Myeloblastic Leukaemia Children Mali

Pseudotumoral Chronic Subdural Hematomas on Two Cases

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Open Journal of Modern Neurosurgery 2018年第1期8卷 72-76页

作者： Essossinam kpélao kadanga Anthony Békéti komi Egu komlan Messan Hobli Ahanogbe Abd El kader Moumouni Agbeko komlan Doléagbenou Essolim Hodabalo Bakondé abdoul k.rim Ouiminga Service de Neurochirurgie CHU Sylvanus Olympio Lomé Togo Service de Neurochirurgie CHU Yalgado Ouagadougou Burkina Faso

Introduction: Calcified forms with pseudo-tumor symptomatology of chronic subdural hematomas are rare. They are the result of slow bleeding over several years. The main etiology is related to the complications of the ventriculo-peritoneal shunt (VP). The purpose of this study was to recall the peculiarities and physiopathology of its pseudotumoral hematomas through 2 observations. Observation: Case 1: 8-year-old patient with a history of ventriculoperitoneal shunt at 3 months of age for congenital hydrocephalus, was admitted for functional impotence of the left-side of the body of insidious onset spreading over 9 months in a chronic headache, blurred vision and generalized seizure. CT scan showed a heterogeneous subdural hematoma of the right frontoparietal with calcifications. The patient underwent an excision by morcellation of a yellowish, friable partly calcific mass. The postoperative history was marked by a total recovery of the neurological deficit. There was no recurrence at 6 months postoperatively. Case 2: 11-year-old adolescent, treated with VP shunt at 6 months of age for post-meningitic hydrocephalus, was admitted for helmet headache, dizziness, lightheadedness and apathy progressing for 3 years. CT scan showed hypodensity of right peri-hemisphere with calcified linings, exerting a mass effect on the medial structures. The patient was given a block excision of a calcific mass with blood content. The evolution was marked by the complete resolution of seizures and hemiparesis. There was no recurrence at 6 months postoperatively. Conclusion: Calcified subdural hematomas are rare and consecutive to the complications of VPS. The clinical signs are those of a benign brain tumor. Treatment is dominated by the difficulties of cerebral reexpression.

关键词： Calcified Subdural Hematomas Pseudo Tumor Symptomatology Overdrainage

Epididymo-Testicular Tuberculosis: A Case Report from Bamako

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Surgical Science 2023年第3期14卷 197-202页

作者： Coulibaly Amara Mamadou Almamy keita Moussa Sissoko Drissa kaloga Bagayoko Cheickna Tounkara Idrissa Tounkara abdoul k.rim simaga Bakary Coulibaly Sidiki konaré Adama Drabo Seydou Sissoko Sekou koumaré abdoulaye Diarra keita Soumaila General Surgery Department Reference Health Center of The Second Municipality of Bamako Bamako Mali Department of Surgery of The CHU du Point G Faculty of Medicine and Odontostomatology of Bamako Bamako Mali

We report a case of epididymo-testicular tuberculosis in a 31-year-old man in the surgical department “A” at the University Hospital Point G of Bamako. Epididymitis or orchi-epididymitis is an infection of the epididymis and/or testis. It is the most frequent reason for consultation in urology and affects mainly young people between 30 and 50 years of age. Mycobacterium tuberculosis is very rarely incriminated (2% to 3% of cases). The main problem with genital tuberculosis lies in the diagnosis, which is often difficult and delayed in the absence of other suggestive locations, a notion of contagion or a history of tuberculosis. In the absence of germs in the urine or semen, the diagnosis of certainty is based on histological examination of biopsy fragments of the testicle or epididymis. Delayed treatment results in impaired fertility, such as oligospermia or azoospermia due to reversible or irreversible organic damage to the genitalia.

关键词： Tuberculosis Epididymis Testicle

Congenital Heart Disease in Newborns: Epidemiological and Clinical Particularities in a Neonatology Department in Mali

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Open Journal of Pediatrics 2022年第5期12卷 857-866页

作者： abdoul k.rim Doumbia Oumou koné Adama Dembélé Noumou Sidibé Noel Banou Hawa Gouro Diall Pierre Togo Oumar Coulibaly karamoko Sacko Djéneba konaté Tati simaga Lala Ndrainy Sidibé Fatoumata Léonie Diakité Boubacar Diarra Guédiouma Dembélé Belco Maïga Mohamed Elmouloud Cissé Hawa konaré Aminata Doumbia Ibrahim Ahamadou abdoul Aziz Diakité Fatoumata Dicko Traoré Boubacar Togo Department of the CHU Gabriel Touré Bamako Mali

Introduction: Congenital heart disease is an important cause of mortality, chronic morbidity, and disability in children in poor countries. The objective of this study was to highlight the diversity of congenital heart defects in the neonatology department. Methodology: This work had taken place in a neonatology service over a period of six months from January 2019 to June 2019. It was a prospective descriptive study with information collected from the medical records of newborns with congenital heart disease. Results: Of 1478 neonates hospitalized during the study period, 41 had congenital heart disease, for a hospitalization rate of 2.77%. CHD accounted for 2.77% of neonatal hospitalizations. The sex ratio was 1.73 (26 boys/15 girls). Consanguinity was found in 19% of cases. The average time to consultation was 11 days. The main clinical signs were heart murmur (58%), respiratory distress (56%) and extracardiac malformations (54%). The main cardiac malformations found were atrial septal defect (46%), patent ductus arteriosus (44%), ventricular septal defect (17%), complete atrioventricular canal (15%), and transposition of the great vessels (5%). The case fatality rate was 29%. Conclusion: Delayed diagnosis, generally related to the long delay in consultation, and lack of surgical management partly explain this high case fatality.

关键词： Congenital Heart Disease Neonates Management

Digestive Surgical Emergencies at the “Mother Child”Hospital Center Luxembourg in Mali

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Surgical Science 2024年第5期15卷 299-310页

作者： Cheickna Tounkara Amara Coulibaly Yaya Ongoiba Aboubakrine Sylla abdoul k.rim simaga Bréhima B. Coulibaly Aminata Dabo Souleymane Dembele Samake Hamidou Sidiki keita Sékou Bréhima koumare Soumaïla keita Bakary Tientigui Dembele Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the “ Mother Child&#8221 Hospital Center Luxembourg Bamako Mali Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery “ A&#8221 and Cardiovascular of Point G University Hospital Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.

关键词： Emergency Digestive Surgery Post-Operative Complication

Non-Chemotherapy Medullary Aplasia in the Pediatric Oncology Unit of the Gabriel Touré Teaching Hospital, Bamako

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Open Journal of Pediatrics 2023年第6期13卷 798-806页

作者： Pierre Togo Ibrahim Ahamadou Tati simaga abdoul k.rim Doumbia Fousseyni Traoré Oumar Coulibaly Djénéba konaté Salif Zigmé Adama Dembélé Mohamed Elmouloud Cissé Belco Maïga karamoko Sacko Hawa Gouro Diall Boubacar Ali Touré Amadou Touré Yacouba Aba Coulibaly Aminata Doumbia Hawa konaré kalirou Traoré Souleymane Sagara abdoul Aziz Diakité Fatoumata Dicko Cheick Bougadari Traoré Boubacar Togo Department of Pediatrics Gabriel Touré Teaching Hospital Bamako Mali National Institute for Training in Health Sciences Bamako Mali Center for Research and Fight against Sickle Cell Disease Bamako Mali Pathological Anatomy Department Point G Teaching Hospital Bamako Mali

Objectives: The main objective was to study the epidemiological, diagnostic and therapeutic aspects of medullary aplasia (MA). Methods: This was a prospective and descriptive retro study conducted from January 1, 2008 to December 31, 2018 in the pediatric oncology unit of the pediatrics department of the Gabriel Touré teaching Hospital in Bamako. Results: We collected 29 children’s cases out of 1632 admissions during the study period, representing a frequency of 1.8% and an incidence of 2.6 cases per year. The sex ratio was 2.6. The 11 - 15 age group accounted for 45%, with an average age of 8.93 years. The majority of fathers (55.2%) and mothers (62.1%) had received no education;they were mainly farmers (62.1%) and housewives (86.2%). The average consultation time was 92.21 days. Anemia was the reason for consultation in 69% of cases. Pallor was present on admission in 96.5%;infectious syndrome accounted for 79.3%, anemic syndrome for 51.7% and hemorrhagic syndrome for 27.6%;the three syndromes were associated in 27.6%. Malaria was associated with bone marrow aplasia in 58.6%. Anemia was present in 93.1%, neutropenia in 65.5% and thrombocytopenia in 86.2%. All had received a labile blood product (LBP) transfusion, and 24 (83%) had received antibiotics. Patients were treated with corticosteroids (58.6%), androgens (20.7%) and immunosuppressants (20.7%). The death rate was 34.6%. At last count, 15 (83%) had discontinued treatment, 2 (11%) were undergoing treatment and 1 (6%) was in remission. Conclusion: Effective treatment of MA requires improved technical facilities and better economic conditions for parents.

关键词： Medullar Aplasia Children Bamako