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Vulvectomy: Indications and Results in the General Surgery Department of the Ignace Deen Chu Hospital in Conakry

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 560-564页

作者： camara Mariama Barry Mamadou Sakoba Yattara Abdoulaye Touré aboubacar Department of General Surgery H&#244pital National Ignace Deen Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: The aim of this study was to report the indications and evaluate the results of vulvectomy in the general surgery department of Ignace Deen Hospital, CHU Conakry. Materials and Methods: This was a retrospective descriptive study, conducted over a period of five (05) years from January 1, 2018 to December 31, 2022, in the general surgery department of Ignace Deen Hospital, CHU Conakry. We included in our study all patient records in whom vulvectomy was performed. Results: We recorded 15 cases of vulvectomy out of 453 perineal surgeries, i.e. 3.31%, with a mean age of 43.56 years and extremes of 35 and 69 years. Vulvar cancer was the most common diagnosis (46.67%), followed by Buschke-Lowenstein (33.33%) and anal canal cancer extending to the vulva (20%). Six patients had undergone biopsy (40%). Vulvectomy with lymph node dissection was performed in only 9 patients (60%), and all surgical specimens were sent to anatomical pathology (100%). Conclusion: Vulvectomy is a surgical technique most often indicated for the treatment of vulvar cancer.

关键词： Vulvectomy Indications Results Ignace Deen Conakry University Hospital

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水分管理和外源硒对水稻吸收累积铅的影响

环境科学 2018年第10期39卷 4759-4765页

作者：万亚男刘哲 aboubacar Younoussa camara 余垚王琪李花粉中国农业大学资源与环境学院农田土壤污染防控与修复北京市重点实验室北京100193

通过盆栽试验,研究了不同水分管理和外源亚硒酸盐的添加对水稻根际铅的动态变化和水稻吸收累积铅的影响.结果表明,淹水显著增加了根表铁膜对铅的吸附和根系对铅的吸收,淹水下苗期和成熟期水稻根系铅含量分别是非淹水处理时的4.2~8.5和1.... 详细信息

通过盆栽试验,研究了不同水分管理和外源亚硒酸盐的添加对水稻根际铅的动态变化和水稻吸收累积铅的影响.结果表明,淹水显著增加了根表铁膜对铅的吸附和根系对铅的吸收,淹水下苗期和成熟期水稻根系铅含量分别是非淹水处理时的4.2~8.5和1.4~1.5倍;淹水降低了地上部的铅分配,在苗期和成熟期分别降低85.9%~86.7%和51.8%~74.0%.加硒降低了土壤溶液、苗期水稻根系和地上部的铅含量以及成熟期水稻根表铁膜、根系和茎中的铅含量.与对照相比,淹水和非淹水下加硒处理使苗期水稻根系铅含量分别降低了5.4%~24.3%和2.7%~61.7%,使成熟期水稻根系铅含量分别降低了56.1%~64.1%和53.8%~63.2%.水稻籽粒中的铅含量在不同处理间无显著差异.因此,水分管理和外源硒的添加显著影响了水稻根系对铅的吸收,而对水稻籽粒对铅的累积无显著影响.

关键词：铅水稻水分管理亚硒酸盐吸收累积

Damage to the External Genitalia by Traction Following Assault and Battery at the C.H.U Gabriel Touré: About a Case

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Surgical Science 2023年第2期14卷 55-60页

作者： Karembé Boubacar Traoré Boureima Tounkara Idrissa Diarra Issaka Coulibaly Mamadou Tidiani Soumaré Modibo Dianguina Coulibaly Abdoulaye camara aboubacar Touré aboubacar Sanogo Seydou Fall Ibrahim Diakité Mané Diarra Mouminy Traoré Abdoulaye Diarra Drissa Diakité Mamadou Lamine Départment of Surgery CHU Gabriel Touré Bamako Mali

Trauma to the external genitalia by tearing is rare. We report the case of a 30-year-old patient, admitted to the emergency room for trauma of the external genitalia by traction following a blow and intentional injury. The authors highlight the lesions that can occur during this type of trauma and insist on the systematic search for urethral and cavernous lesions. Conclusion: Trauma to the external genitalia by intentional assault and battery is rare in our context. They occur most often in a young person and are frequently associated with damage to the corpora cavernosa and urethra.

关键词： Trauma External Genitalia Traction

Epidemiological-Clinical and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune III (C.S.Ref CIII) of the District of Bamako

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Surgical Science 2023年第1期14卷 30-37页

作者： Karembé Boubacar Tounkara Idrissa Soumaré Modibo Dianguina Diarra Issaka Diarra Mouminy Touré aboubacar Traoré Boureima camara aboubacar Sanogo Seydou Fall Ibrahim Coulibaly Abdoulaye Traoré Abdoulaye Diarra Drissa Diakité Mané Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: It was to determine the epidemiological-clinical and therapeutic aspects of acute appendicitis at the Reference Health Center of Commune III of the district of Bamako. Methodology: This was a prospective study from January 1 to December 31, 2020 including patients operated for acute appendicitis and confirmed at histology and cases of abscess and appendicular plastron. Results: We collected 60 cases of acute appendicitis. They accounted for 17.29% of surgical indications. The average age of our patients was 25.5 years. The male sex was the most represented at 63% with a sex ratio of 1.72. The Pain in the right iliac fossa was the most represented reason for consultation with 76.7%. It was at the type of bite 70% of the cases. On physical examination the defense of the right iliac fossa was present in 96.7%. Digestive signs were marked by nausea 28.4% (17 patients) and vomiting 25% (15 patients). The digital rectal exam was painful to the right of the Douglas fir in 76.7% of our patients. In biology a complete blood count (CBC) performed in all our patients has objectified hyper leukocytosis in 80% of cases. The reactive protein (CRP) performed in 36 patients was elevated with values between 18 and 46 mg/ml. The imaging performed was an abdominal ultrasound that found a roundel image of the appendix with increased size in 65%. Surgical treatment consisted of classical Mac Burney appendectomy in 54 patients (90%). The gesture performed was an appendectomy in all our patients. All our appendectomy parts were sent for pathological examination. This examination classified the parts as non-specific appendicitis in 60%, phlegmonous appendicitis in 22% and catarrhal appendicitis in 18% of cases. Surgical follow-up was simple in 98.4% (59 patients) and morbidity was marked by digestive fistula in one patient. We recorded one case of death (1.6%). Conclusion: Acute appendicitis remains the most common surgical emergency in commune III of the district of Bamako. It is a pathology that can be found at all ages of

关键词： Appendicitis Surgery Anatomical Pathology

Appendicular Abscess: Epidemio-Clinical and Therapeutic Aspects in the General Surgery Department of the Reference Health Center of Commune III (C.s.ref CIII) of the District of Bamako

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Surgical Science 2023年第2期14卷 77-83页

作者： Karembé Boubacar Tounkara Idrissa Diarra Issaka Soumaré Modibo Dianguina Traoré Boureima Sanogo Seydou Diallo Moctar camara aboubacar Touré aboubacar Coulibaly Abdoulaye Fall Ibrahim Diakité Mané Diarra Mouminy Diarra Drissa Traoré Abdoulaye Coulibaly Yacaria Kanté Lassana Dembélé Bakary Tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: The main goal of this study is to determine the hospital frequency of appendicular abscess, to describe the diagnostic and therapeutic aspects and to analyze the postoperative follow-up. Methodology: This was a descriptive and analytical prospective study from January 1, 2020 to June 30, 2021 including patients admitted to our department for appendicular abscess diagnosed pre- and or intraoperatively and confirmed to histology. Results: We collected 30 appendicular abscesses that accounted for 18.75% of emergency interventions. The 16 - 25 age group was the most represented at 53%. The average age was 24 years with extremes of 10 and 58 years. The male sex was mostly represented (60%) with a sex ratio of 1.5. The majority of our patients were students (53.3%). The main clinical signs found were abdominal pain and vomiting (100%). The pain was localized in the Right Iliac Fossa (RIF) in 80% of cases. Fever was present in all our patients with a temperature between 38˚C and 38.5˚C. The physical examination found pain with defense of the right iliac fossa in 93.3% of cases. A painful mass was present in 27 patients (90%). Treatment consisted of appendectomy with abscess drainage in all patients. Postoperative follow-up was simple in 83.3% of cases;we recorded three cases (10%) of parietal suppuration, one case of fistula (3.3%) and one death. Conclusion: Appendicular abscess is a medical-surgical emergency frequent surgery in our context because of the delay in diagnosis. It is a condition with low morbidity and mortality subject to early diagnosis and prompt and appropriate treatment.

关键词： Abscess Appendix Surgery

幼鼠MTLE模型的建立及TLR4、IL-1β与其发病机制关系的初步探讨

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幼鼠MTLE模型的建立及TLR4、IL-1β与其发病机制关系的初步探讨

作者： camara aboubacar Damaye（达玛伊）中南大学

学位级别：硕士

癫痫是小儿神经系统最常见疾病之一,主要表现为脑内局部或广泛的痫性放电引起反复、自发的痫样发作（包括痉挛或非痉挛性发作形式）。而且即使是成人癫痫,起病年龄在15岁以下者也接近50%。长期、频繁的癫痫发作可对患儿智能发育、学习... 详细信息

癫痫是小儿神经系统最常见疾病之一,主要表现为脑内局部或广泛的痫性放电引起反复、自发的痫样发作（包括痉挛或非痉挛性发作形式）。而且即使是成人癫痫,起病年龄在15岁以下者也接近50%。长期、频繁的癫痫发作可对患儿智能发育、学习记忆等造成永久性损害,因此控制癫痫发作不仅能有效改善患儿未来的工作和生活质量,也对减轻家庭和社会负担具有重要意义。随着抗癫痫新药的涌现和手术术式的改良,临床上一部分癫痫患儿经早期合理抗癫痫治疗后发作可得到有效控制,然而仍有1/3的癫痫患儿疗效难以令人满意,最终发展成为难治性癫痫（intractable epilepsy, IE）,严重影响患儿的智力发育。难治性癫痫中,以颞叶内侧癫痫（mesial temporal lobe epilepsy, MTLE）最为常见,其多数起源于颞叶海马,具有复杂部分运动性发作的临床特征,多在10岁左右发病,约占全部癫痫患儿的10～30%。迄今为止,仍有大约70%的MTLE患儿经药物治疗及手术治疗均未能取得满意的疗效。因此,深入探讨MTLE的发病机制,对于寻找新的药物治疗靶点和改善患儿预后具有重要意义。已有研究表明,海马是MTLE的解剖起源,以神经元坏死、丢失和胶质增生为主要特征的海马硬化是导致MTLE普遍难治的最常见且最具特异性的病因,其中海马神经元重组以及苔藓纤维出芽,形成异常神经网络是反复自发痫性发作（spontaneous recurrent seizures, SRS）的主要环节。目前认为MTLE合并海马硬化的形成原因与婴幼儿时期的海马区各种损伤（外伤、热性惊厥、癫痫持续状态等）有关,并在经历经数月至数年的潜伏期后出现导致自发痫性发作,但其具体机制尚不明确。当下对MTLE的研究多以成年动物模型和临床术后标本为基础,但绝大多数研究在疾病已完全形成的阶段进行,并不能反映病程中体内环境的动态性改变。而婴幼儿期神经系统损伤后所致的慢性MTLE是一个长期的动态过程,探明在此过程中引导癫痫发生的损伤因素,观察在自发痫性发作前这些损伤因素引起的病理过程,并研究大脑在癫痫各期的改变,对了解MTLE的病理生理特点及寻找新的药物治疗靶点至关重要。此外,发育期的大脑的结构与功能尚未发育成熟,与成熟的大脑比较,在癫痫致病因素、发生发展、临床和脑电图（EEG）表现、对抗癫痫药物的治疗反应性以及预后上亦存在很大区别。因此,有必要建立与小儿颞叶内侧癫痫发生发展相似的幼鼠慢性MTLE模型,这对研究海马发育早期阶段受损后产生成年期癫痫发作的发病机制及可能的早期干预措施有着十分重要的意义。以往对MTLE的机制研究主要集中在神经再生和突触可塑性、离子通道、神经传递和信号传导、神经细胞损伤、细胞骨架的改变、细胞代谢和蛋白合成等各个方面。而由于血脑屏障的存在,长期以来,中枢神经系统（CNS）被认为是一个免疫豁免的场所,因此MTLE一直被认为是一个非炎症性疾病。然而近年来的研究表明炎症反应可能参与了MTLE的发生和发展。Toll-样受体-4（Toll-like receptor-4,TLR4）是固有免疫反应中能识别病原体成分的重要分子,在脑组织中主要表达于星形胶质细胞、小胶质细胞及神经元上。通常情况下,TLR4与其配体结合后促使核转录因子κB （NF-kappaB, NF-κB）活化,导致白细胞介素-1beta （IL-1β）和肿瘤坏死因子-alpha （TNF-a）等炎症介质的生成,最终产生炎症反应。癫痫病人手术切除的海马组织中,TLR4、IL-1β及其受体表达增高,炎症细胞浸润增多。临床观察显示,在伴有海马硬化的颞叶癫痫成人患者中有相当高的比例可以追问到儿童早期有热性惊厥病史,且热性惊厥模型小鼠海马内IL-1β表达水平增高。对癫痫动物模型的研究发现,LPS-TLR4相互作用可促使大鼠产生痫样放电,而IL-1beta受体拮抗剂预处理后则能明显抑制LPS-TLR4的致痫作用。上述结果强烈提示：海马内的炎症过程,尤其是TLR4、IL-1p参与的炎症反应可能与MTLE的发生密切相关。因此,研究发育阶段幼鼠痫性发作后海马内TLR4、IL-1beta动态改变与癫痫发生发展的关系对明确炎症、免疫反应是否参与海马早期损伤及了解炎症在MTLE发生过程中各阶段的作用有重要意义,但目前国内外相关报道少见。因此,本实验中,我们以21日龄（相当于人类婴幼儿阶段）幼鼠为研究对象,选用氯化锂联合匹罗卡品致痫,建立发育早期海马受损致成年后癫痫的大鼠慢性MTLE模型,并结合免疫组化、免疫印迹分析和RT-PCR的方法,检测MTLE不同时期海马组织各区域内TLR4,IL-1β表达水平的动态变化及该变化与海马硬化的关系,证实炎症反应是MTLE早期损伤因素,与海马硬化密切并参与了MTLE发病全过程。对此问题的探讨有助于从一个全新的角度研究MTLE的发病机制,不仅能从病因方面为MTLE的治疗提供新的靶点,还有可能寻找到MT

关键词：内侧颞叶癫痫发育期大鼠炎症反应 Toll样受体4 白介素1β

Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

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Surgical Science 2019年第2期10卷 49-58页

作者： Kéita Soumaila Traoré Youssouf Soumaré Lamine Koumaré Sekou Sacko Oumar camara aboubacar camara Moussa Sissoko Moussa Abdoulaye Sissoko Koita Adama Sanogo Z. Zimogo Surgery Department “A” Point G Teaching Hospital Bamako Mali Faculty of Medicine and Odonto Stomatology of Bamako University of Science Technique and Technologies of Bamako (USTTB) Bamako Mali

The endoscopic surgery is actually the golden standard for the management of infertility. Its results look better than classical surgery. The aim of the study was to assess the fertility rate among infertile women who have undergone a laparoscopic distal tubal plasty and to estimate factors influencing this fertility. From January 2007 to December 2016 a descriptive and analytical cross sectional retrospective study was conducted in the departments of general and laparoscopic surgery of the Point “G” Teaching Hospital in Bamako, Mali. Clinical records of 120 laparoscopic patients with distal tubal occlusion who have undergone a neosalpingostomy were collected. Average period of infertility was 6.7 years (from 1 to 25 years), and the average duration before laparoscopic surgery was 5 years. Main abnormalities were: 50 cases of bilateral tubal distal occlusion (41.7%), 14 patients with unilateral tubal distal occlusion (11.7%), 44 cases of bilateral hydrosalpinx (36.6%) and 12 cases with unilateral occlusion (10.0%). Seventeen patients had adhesions (14.1%) including 4.0% of tubo-peritoneal adhesions, 35.5% of tubo-ovary adhesions and Fitz Hugh and Curtis syndrom adhesions in 17.7% of cases. More than half of the patients (58.0%) had a grade II tubal score. Neosalpingostomy had led to bilateral tubal repermeabilization among 60.0% of the patients. Thirty two point five percent (39/120) pregnancies have been observed after the management. Conception probability was null after the 4th post operative year. The majority of pregnancies have been observed in the 11th month after laparoscopic management. During the follow-up, thirty one patients had intrauterine pregnancy (79.5%), four ectopic pregnancies and three miscarriages. The occurrence of pregnancy was influenced by the desire of the woman, the absence of co-morbidity, the tubal score, the result and the quality of the laparoscopic gesture and the duration of the fertility. Conclusion: In our working setting, neosalpingostomy by laparoscopic surgery is an accessib

关键词： Fertility Laparoscopy Neosalpingostomy Pregnancy

Management of Vulnating Esophageal Foreign Bodies in Burkina Faso

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International Journal of Otolaryngology and Head & Neck Surgery 2024年第2期13卷 135-148页

作者： Ibrahima Diallo aboubacar Gouéta Alseny camara Assoumi Anatou Biga Mama Brigitte Ouoba Edi Emmanuel Martial Nao Moustapha Sérémé Bertin Priva Ouédraogo Yvette Marie Chantal Gyébré Abdoulaye Keita Alpha Oumar Diallo ENT and HNS Department Yalgado Ouédraogo University Hospital Ouagadougou Burkina Faso ENT and HNS Department Bogodogo University Hospital Ouagadougou Burkina Faso ENT and HNS Department Tengandogo University Hospital Ouagadougou Burkina Faso ENT and HNS Department Conakry University Hospital Conakry Guinea

Introduction: Esophageal foreign bodies (EFB) are a diagnostic and therapeutic emergency because of the serious complications they can cause. Aim: This paper aimed to study the vulnating esophageal foreign bodies in the ENT and Head and Neck Surgery departments of the Yalgado Ouedraogo and Bogodogo University Hospital. Methodology: This was an analytic cross-sectional study with retrospective data collection over 10 years (2012-2021). Results: We collected 91 cases of vulnating esophageal foreign bodies, i.e. 9.1 cases/year (4.7%). The mean age of the patients was 14 ± 19 years. The sex ratio was 1.6. The circumstances of occurrence were dominated by accidental ingestion of vulnating esophageal foreign bodies (98.9%). The average time to consultation was 7.5 hours. Dysphagia was the dominant symptom (64.8%). Cervico-thoracic radiography found dual contour radiopaque images in 71.4%. Esophagoscopy with rigid tube was performed in 97.8%. The average time for extraction of the vulnating esophageal foreign bodies was 8 hours. Vulnerating esophageal foreign bodies were non-organic in 84.6%. The button cell represented 64.8%. Their location was cervical in 61.5% intraoperatively. The lesion assessment found ulcerative lesions in 42.9% (p Conclusion: Vulnating esophageal foreign bodies are relatively frequent in our ENT practice. Although their diagnosis is often easy, their treatment is still difficult and requires multidisciplinary management. Thus, for us, prevention remains the first effective weapon.

关键词： Foreign Bodies Esophagus Vulnerable Management Sequelae

Relevance of Medical Imaging in the Pre-Therapeutic Evaluation of Acute Intestinal Obstruction at CIMED

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Open Journal of Medical Imaging 2024年第1期14卷 31-41页

作者： Mamoudou camara Aly Mampan Koundouno Siré Nabe Toumin camara Ousmane Aminata Bah Center for Medical Imaging Exploration and Diagnostics University of Conakry Conakry Guinea General Surgery Department of the Kankan Regional Hospital Kankan Guinea Ministry of Health and Public Hygiene Conakry Guinea General Medicine Department of the Siguiri Prefectural Hospital Siguiri Guinea CIRA Conakry Guinea

Objective: We initiated this work with the aim of studying the contribution of imaging in the diagnosis of acute intestinal obstruction at CIMED. Patients and methods: This was a prospective, descriptive and analytical study involving 96 patients collected at the radiology and medical imaging department of CIMED, from January 2022 to January 2023. Result: The age of our patients varied between 11 and 86 years with an average age of 36 years. There was a male predominance of 64.6% compared to 35.4% for women, i.e. a sex ratio of 1.82. The notion of previous surgery was found in 61.5% of our patients. Pain was present in all patients. Radiography of the ASP was performed in 89.6% of patients. It showed hydro-aerial levels in 96.5% of patients. Abdominopelvic CT was performed in 12 patients and made it possible to make the diagnosis of occlusion in all patients. The results of the positive diagnosis were concordant with those intraoperatively in 92% of cases. 8% of our patients, compared to the treatment, spontaneously resumed their transit, 91% benefited from surgical treatment and 1% died before surgery. The outcome was favorable in 80 patients or 83.3%, poor with death in 16 patients or 16.7% of cases. Conclusion: Acute intestinal obstruction remains a serious pathology for which ASP radiography often remains the only radiological examination performed urgently. However, abdominopelvic CT seems widely indicated thanks to its contribution both for the positive diagnosis and for the serious and etiological diagnoses. However, this imaging technique is largely underused in our practice due to its high cost and lack of availability.

关键词： Imaging Acute Intestinal Obstruction CIMED