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Laparoscopic Appendectomies at Brazzaville University Hospital

Surgical Science 2024年第4期15卷 183-194页

作者： Murielle Etiennette Julie Note Madzele Pierlesky Elion Ossibi Bhodeho Medi Monwongui Didace Massamba Miabaou Giresse Bienvenu Tsouassa Wa Ngono Prude Pertinie Avala Gilles Niengo Outsouta Noé Henschel Motoula Latou carmich nzaka moukala Cédrick Du Bonheur Alima Koya Gilbert Fabrice Otiobanda Digestive Surgery Department Brazzaville University Hospital Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo General Intensive Care Unit Brazzaville University Hospital Brazzaville Republic of the Congo

Introduction: Acute appendicitis represents an urgent surgical condition, requiring the removal of the vermiform appendix. Laparoscopy is the standard surgical approach. This study aimed to outline the epidemiological, clinical, therapeutic, and outcome characteristics of patients undergoing laparoscopic surgery for acute appendicitis. Patients and Methods: A descriptive, retrospective analysis was carried out in the Emergency and Digestive Surgery departments of the University Hospital Center of Brazzaville, spanning two years from January 1, 2021, to December 31, 2022. The study included all patients who underwent laparoscopic surgery for non-complicated acute appendicitis. Results: The study included 12 cases of non-complicated acute appendicitis treated with urgent laparoscopy. The mean age of the patients was 37 ± 8.9 years, with a sex ratio of 0.7. The predominant symptom leading to consultation was pain in the right iliac fossa, with an average time to consultation of 6.4 ± 5.7 hours. Patient histories included diabetes in one case, obesity in two cases, and one case of prior abdominoplasty. During surgery, a phlegmonous appendix was observed in nine patients. The average duration of hospital stay was 3.6 ± 1.3 days, with all patients experiencing uncomplicated recoveries. Conclusion: The practice of emergency laparoscopic appendectomy is still relatively infrequent in our setting and presents an ongoing challenge.

关键词： Acute Appendicitis Appendectomy Laparoscopy Emergency

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Surgical Treatment of Hemorrhoidal Disease at Brazzaville University Hospital Center

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Surgical Science 2024年第3期15卷 159-168页

作者： Murielle Etiennette Julie Note Madzele Pierlesky Elion Ossibi Rody Stéphane Ngami Didace Massamba Miabaou Clausina Philestine Mikolele Ahoui Apendi Noé Henschel Motoula Latou Bhodeho Medy Monwongui Giresse Bienvenu Tsouassa Wa Ngono Prude Pertinie Avala carmich nzaka moukala Cédrick Du Bonheur Alima Koya Blaise Irénée Atipo-Ibara Digestive Surgery Department Brazzaville University Hospital Center Brazzaville Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Congo Gastroenterology and Internal Medicine Department Brazzaville University Hospital Center Brazzaville Congo

Introduction: Hemorrhoidal disease is a common pathology and its surgical treatment is based, among other things, on pedicular resection after failure of medical and instrumental treatment. The aim of this study is to analyze the epidemiological, clinical, therapeutic and evolving aspects of hemorrhoidal disease at the stage of surgical treatment at the University Hospital Center of Brazzaville. Patients and Methods: We conducted a retrospective and descriptive study carried out from January 2020 to December 2021, a 24 months period, in the Digestive surgery department of the University Hospital Center of Brazzaville. It concerned patients who underwent a surgical procedure for hemorrhoidal disease. Results: 21 cases were collected, representing a hospital frequency of 2.3%, with a sex ratio of 4.3 in favor of men. The average age of patients was 42.2 ± 11.9 years. The symptoms were mainly proctalgia, mass sensation and rectal bleeding. We recorded five cases (19.1%) of hemorrhoidal thrombosis and 16 cases (80.9%) of hemorrhoidal prolapse including 12 cases requiring manual integration (Goligher grade III) and four irreducible permanent cases (Goligher grade IV). The Grade III prolapse was associated with a polyp in one patient and with posterior anal fissure in another patient. Out of the 21 patients, 14 underwent a tripedicular hemorrhoidectomy according to Milligan and Morgan. Two patients underwent mono- and bipedicular hemorrhoidectomy with resection of associated lesions and five patients underwent emergency thrombectomy. The outcome was favorable for all our patients. The average length of hospital stay was 1.5 ± 2.1 days. Conclusion: In the event of failure of medical and instrumental treatment, the hemorrhoidal cure according to Milligan and Morgan is the surgical treatment of reference for hemorrhoidal disease at the University Hospital Center of Brazzaville.

关键词： Hemorrhoidal Disease Surgery Milligan and Morgan

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Recurrent Sigmoid Volvulus after Sigmoidectomy: 3 Clinical Cases

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Surgical Science 2023年第12期14卷 712-719页

作者： Murielle Etiennette Julie Note Madzele Didace Massamba Miabaou Pierlesky Elion Ossibi Moïse Service Yanguedet Noé Henschel Motoula Latou Prude Pertinie Avala Giresse Bienvenu Tsouassa Wa Ngono Meddi Bhodého Monwongui carmich nzaka moukala Department of Digestive Surgery University Hospital Center of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Introduction: Recurrent sigmoid volvulus is a medical and surgical emergency. It is the recurrence of a twisting of the sigmoid loop around its mesenteric axis initiating an occlusion by strangulation. The risk factors of colonic volvulus are: a dolichosigmoid, a chronic constipation, a tumor, …In Western countries, recurrences of sigmoid volvulus after surgery are rare and due to a non resection of a dolicho-megacolon. Most African studies do not report any recurrence of sigmoid volvulus after sigmoidectomy. This work aims to describe three original cases of recurrence of sigmoid volvulus after sigmoidectomy recorded at the University Hospital of Brazzaville and to analyze their causes and surgical management. Clinical Observation: We studied the cases of three male patients, whose average age was 73 years, each of them having a history of chronic constipation and sigmoidectomy for sigmoid volvulus with an average delay of recurrence of 5.3 years. They all underwent emergency laparotomy for acute intestinal obstruction on scarred abdomen. The surgery permitted to unfold a recurrent volvulus of the sigmoid associated with circumferential scar fibrosis on the volvulated sigmoid loop. A second colectomy was performed. The histological results of the surgical specimens were normal for two patients and revealed signs of tissue necrosis for the third patient. The postoperative outcome was without incident for two patients. The third patient died after developing a septic shock. Conclusion: Recurrent sigmoid volvulus after sigmoidectomy is rare. The etiological factors for our three patients were incomplete sigmoidectomy during the first operation and chronic constipation.

关键词： Recurrent Volvulus Sigmoid Sigmoidectomy

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