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Skin Graft in the Surgery Department “B” of the CHU du Point “G” about 50 Cases

Surgical Science 2020年第7期11卷 187-193页

作者： Mahamadou Coulibaly Bréhima Bengaly Drissa Ouattara Traoré Drissa diallo siaka Souleymane Sanogo Birama Togola Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali Department of Surgery Koutiala Hospital Bamako Mali Department of Surgery University Hospital Center Point G Bamako Mali

Aim: To analyze the practice of skin grafting in the surgery department “B” of the CHU of Point “G” in Bamako. Patients and Methods: This was a retrospective and prospective study carried out between 1980 and 2014, covering all patients who underwent a skin graft and hospitalized. It covered all patients who underwent a skin transplant and were hospitalized in the department during the study period. Result: There were 50 patients including 25 women and 25 men. The mean age was 25.2 ± 19 years. The average duration of lesion evolution was 1 year. The lesions to be grafted were located in the lower limbs in 60%. The average area of substance loss was 13.2 cm2. The indication for skin graft was asked for loss of substance following scar bridles in 40%, ulcerative-necrotic wounds of infectious or traumatic origin (32%), malignant skin tumor (14%). In pathology, there were 5 cases of malignant melanoma and 2 cases of squamous cell carcinoma. Thin skin grafting was the most used technique (62%). The postoperative follow-ups were simple in 94%. There were 3 cases of graft necrosis. The average length of hospital stay was 28 days. The esthetic result was judged satisfactory in 84% of the cases (n = 42), average in 14% of the cases (n = 7) and unsatisfactory in 2% of the cases (n = 1). The sensitivity was good in 36 patients (72%), average in 12 patients (24%) and poor in 2 patients (4%). Conclusion: They mainly affect young people. The reduction of accidents on the public highway, good management of burn injuries, wounds and good hygiene of the population will considerably reduce the rate of its affections.

关键词： Skin Graft Surgery Postoperative Operations

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Anatomical Dissection of the External Branch of the Superior Laryngeal Nerve to the Laboratory of Anatomy of the Faculty of Medicine of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2018年第4期6卷 47-54页

作者： Abdoulaye Kante Youssouf Sidibe Babou Ba Brehima Bengaly Brehima Coulibaly Drissa Traore Drissa Ouattara Mariam Daou Tata Toure siaka Diakite Moumouna Kone siaka diallo Cheickh Tidiane diallo Ousmane Ibrahim Toure Birama Togola Nouhoum Ongoiba Service of Surgery B CHU Point GBamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU Mother-Child“Luxembourg”BamakoMali Service of Neurology CHU Gabriel ToureBamakMali

Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.

关键词： External Laryngeal Nerve Superior Thyroid Artery Anatomy Thyroid Gland Surgery

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Acute Peritonitis Generalized at the Koutiala Reference Health Center, Mali: Epidemiological, Etiological and Therapeutic Aspects

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Surgical Science 2020年第6期11卷 111-116页

作者： Mahamadou Coulibaly Birama Togola Traoré Drissa Bréhima Bengaly Souleymane Sanogo Drissa Ouattara diallo siaka Madiassa Konaté Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali Department of Surgery Koutiala Hospital Bamako Mali Department of Surgery University Hospital Center Point G Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

History: In Mali, several studies have been carried out on acute peritonitis but in the Koutiala circle it is a first. Aim: To evaluate the epidemiological, etiological and therapeutic aspects of generalized acute peritonitis at the Koutiala reference health center. Method: This was a 14-month prospective and descriptive study from August 1, 2017 to November 30, 2019, covering all patients admitted and operated for generalized acute peritonitis. The parameters studied were age, sex, frequency, clinical aspects, etiologies, treatment and postoperative operations. Result: The number was 93 cases, 72 men and 21 women. The average age was 34.2 years (Extremes: 2 - 75 years). The hospital frequency was 2.0%. The incidence rate of generalized acute peritonitis in the circle was 12.4 cases per 100,000 population. The clinical picture was still of peritonitis. The Widal-Félix serology was positive in 19 cases. Perioperative bacteriological sampling was systematic. The etiologies were dominated by digestive perforations in 81 cases (87%) of which 33 were located at the ileal level, postoperative peritonitis (6 cases) and ruptured pyocholecyst (2 cases). There were also 3 cases of primary peritonitis and 1 case of gynecological peritonitis. Excision-suturing was the most used surgical technique with 35.5% (n = 33). Postoperatively, we identified 10 cases of parietal suppuration (10.8%), 6 cases of postoperative peritonitis (6.5%), 2 cases of external digestive fistula (2.2%) and 7 cases of death (7.5%). Conclusion: Acute peritonitis occupies second place in abdominal surgical emergencies in the Koutiala circle. The etiologies are multiple and varied and are dominated by the ileal perforation which is secondary to typhoid fever more often. In most cases the surgical treatment is done by excision-suturing of the perforation. Mortality and morbidity remain high.

关键词： Generalized Acute Peritonitis Emergency Koutiala

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Anatomy of the Brachial Plexus:A Rare Variation in the Laboratory of Anatomy of Bamako(Mali)

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Forensic Medicine and Anatomy Research 2019年第1期7卷 8-12页

作者： Babou Ba Abdoulaye Kanté Drissa Traoré Bréhima Bengaly Mariam Daou Bréhima Coulibaly Drissa Ouattara siaka diallo siaka Diakité Moumouna Koné Tata Touré Cheickh Tidiane diallo Ousmane Ibrahim Touré Birama Togola Nouhoum Ongoiba Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Surgery B.CHU Point G BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

The brachial plexus (BP), established by the lap twigs of the last four cervical nerves and the first thoracic nerve, assures the driving and sensory innervation of the thoracic member. We bring back a case of rare anatomical variation of the brachial plexus. It is a 34-year-old corpse dissected in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in September 2017. The lap twig of the fourth cervical root (C4) participated in the constitution of the brachial plexus. The superior trunk was normally constituted. The average trunk was formed by the cervical roots C7 and C8 instead of only C7. And consequently the inferior trunk was constituted by the thoracic root T1. The posterior beam was only formed by the posterior branches of the superior and more average trunk. The medial beam was formed by all of the inferior trunk which did not give posterior branch for the formation of the posterior beam. The variations of the brachial plexus could entrain failures in the loco regional anesthesia of the brachial plexus.

关键词： Anatomy Brachial Plexus Variation Anesthesia Surgery

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Epidemiological Profile of Intestinal Obstructions in Koutiala, Mali: About 65 Cases

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Surgical Science 2020年第6期11卷 117-121页

作者： Mahamadou Coulibaly Drissa Traoré Birama Togola Souleymane Sanogo Bréhima Bengaly Drissa Ouattara siaka diallo Madiassa Konaté Nouhoum Ongoiba Faculty of Medicine University of Science Technique and Technologies of Bamako Bamako Mali Department of Surgery Koutiala Hospital Bamako Mali Department of Surgery University Hospital Center Point G Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali

Aim: To assess the epidemiological profile of intestinal obstructions at the Koutiala district hospital. Patients and Method: This was a prospective and descriptive study taking place from August 1, 2017 to April 30, 2020. The files of patients with acute intestinal obstruction in the general surgery department of the Koutiala district hospital were collected. In this study, patients operated on for acute intestinal obstruction were included. Non-operated patients were not included in the study. Result: The records of 65 patients operated on for acute intestinal obstruction were collected. The mean age was 32 ± 22 with extremes of 1 year and 94 years. 7 infants (10.8%) and 1 4-year-old child (1.5%) were identified. The 16 to 59 age group was more common. Males were the majority with 70.8% (n = 46). The sex ratio was 2.4. The rate of bowel obstruction in the general population in the circle was 8.1 cases per 100,000 population. According to provenance, patients came from inside the circle (rural areas) in 87.7% of the cases (n = 57) and from the city of Koutiala in 12.3% (n = 8). 33.9% of our patients had undergone laparotomy (n = 22). Patients consulted urgently in 93.8%. The etiologies are dominated by post-operative straps (33.8%) and volvulus (24.6%). We noted 12 cases of intestinal necrosis. Postoperative morbidity was 13.8% of cases (n = 9) and mortality of 6.1% of cases (n = 4). Conclusion: Bowel obstruction is one of the most frequent surgical emergencies in our circle. They most often affect young subjects and young adult males. The etiologies are dominated by the post-operative flanges. Complications remain elevated.

关键词： Epidemiology Intestinal Obstruction Koutiala

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Choked Inguino-Scrotal Hernia and Fistulising in the Scrotum at the Hospital Somine DOLO of Mopti:A Clinical Observation

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Surgical Science 2019年第3期10卷 71-75页

作者： Abdoulaye Kanté Djibril Traoré siaka diallo Drissa Ouattara Bréhima Bengaly Drissa Traoré Moustapha Issa Magané Mariam Daou Nouhoum Ongoiba Service of General Surgery Somine Dolo of Mopti HospitalBamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Surgery B CHU Point GBamakoMali Service of Anesthesia and Resuscitation CHU Gabriel TouréBamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

We report a case of grave and rare surgical complications nowadays, which calls out to us on the necessity of a bigger raising sensitization on the coverage of the constrictions hernial at the adult. It is about a case of right inguino-scrotal hernia choked secondarily complicated with a scrotal coecostomie at a 64-year-old man. The delay in the care was in touch with a traditional treatment but also in the poverty of the patient which was a needy the total care of which was assured by the social services department of the hospital. The perioperative exploration found a cecostomy the mucous membrane of which was inverted in the opening of the stoma, an ulceration of the peristomial scrotum with a normal macroscopic aspect of the testicle homolateral. The care was made at single time: parage and scrotal suture more resection segmental of the coecum followed by an anastomosis ileocolic terminoterminal and a cure of the hernia according to Shouldice. The operating suites were simple with ablation of the threads to operating J12 comment and the liberation of the patient the next day. The clinical evolution was satisfactory with a backward movement of 4 years.

关键词： Choked Grown-Up Hernia Scrotal Coecostomie

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Premature Division of the Inferior Laryngeal Nerve in Surgery and in ENT and Cervico-Facial Surgery in Mali

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Forensic Medicine and Anatomy Research 2019年第1期7卷 1-7页

作者： Drissa Traoré Abdoulaye Kanté Youssouf Sidibé Bréhima Bengaly Bréhima Coulibaly Babou Ba Drissa Ouattara siaka diallo Mariam Daou Birama Togola Nouhoum Ongoiba Service of Surgery B.CHU Point G BamakoMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali ENT and Head and Neck Surgery Department CHU“Mother-Child”BamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery B to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the CHU “mother-child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were included. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the lower laryngeal nerve realized during the surgical operations on the thyroid 95.1% of the cases, the nerve had a single branch;in 4.1% of the cases, the nerve had two branches;and in 0.8% of the cases, the nerve had more than 2 branches. Conclusion: The complications of the thyroid surgery in touch with the hurts of the lower laryngeal nerve are known. However, our study shows that these do not seem to be influenced by the premature division of the lower laryngeal nerve.

关键词： Anatomy Inferior Laryngeal Nerve Recurring Nerve Thyroid Surgery Goiter

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Environmental Risk Factors for Stomach Cancer in an African Setting about 193 Cases at the CHU Point G in Bamako/Mali

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Surgical Science 2021年第2期12卷 23-30页

作者： Souleymane Sanogo Drissa Traoré Mamadou Coulibaly Birama Togola Bréhima Bengaly Ousmane Ibréhima Touré Drissa Ouattara Bréhima Coulibaly Babou Ba siaka diallo Nouhoum Ongoiba Surgery B CHU Point G Bamako Mali USTTB Faculty of Medicine Bamako Mali Koutiala Regional Hospital Koutiala Mali

CHU (University Hospital Center) Point G: The department of surgery B is a surgical department of CHU Point G. The department is par excellence a reference department for cases of visceral surgery, cancer surgery, cardiovascular surgery, plastic and endocrinology surgery. As a reminder, the CHU Point G is the largest 3rd level referral hospital in Mali. Aim: To study the environmental risk factors of stomach cancer in the B surgery department of the Point G University Hospital in Bamako. Patients and Methods: We performed a cross-sectional study with retrospective collection from January 2008 to June 2018 (126 months). Results: We have identified 380 cases of digestive cancer, including 193 cases of stomach cancer or 50.79% of digestive cancers. The mean age of the patients was 57.21 ± 13 years. Male sex represented 55% (n = 106). Eating habits were dominated by the consumption of tô with potash (cereal paste) with 64.76% (n = 185). The main methods of preserving meat and fish were curing and smoking with 57.51% (n = 111). Chronic smoking was found in 24.35% (n = 47), alcohol + tobacco consumption in 2.59% (n = 5). The low socio-economic class represented 126 cases or 65.38%. Housewives and cultivators were respectively 37.82% (n = 73) and 227.97% (n = 54). 20.20% (n = 39) had a history of epigastric pain. Epigastralgia was the most common functional sign with 84.5% of cases (n = 169). An epigastric mass was found in 72 patients or 37.3%. Adenocarcinoma represented 97.4% (n = 188).

关键词： Stomach Cancer Environmental Risk Factors African Setting CHU Point G

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Volvulus Acute of the Colonist Sigmoid to Mopti:Diagnostic and Therapeutic Aspects

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Surgical Science 2018年第11期9卷 446-453页

作者： Bréhima Bengaly Abdoulaye Kanté Drissa Ouattara Bréhima Coulibaly Drissa Traoré Birama Togola Babou Ba Souleymane Sanogo siaka diallo Djibril Traoré Moustapha Issa Magané Mariam Daou Nouhoum Ongoiba Service of Surgery B CHU Point GBamakoMali Service of General Surgery Somine Dolo of Mopti HospitalMali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of Anesthesia and Resuscitation CHU Gabriel TouréBamakoMali Service of Neurology CHU Gabriel TouréBamakoMali

In 7 years, we brought together 100 cases of volvulus of the colon sigmoid to the hospital Sominé Dolo of Mopti among which the handle volvule was found without necrosis in 66 cases and necrosis 34 cases. Seventy-six patients benefited from a sigmoidectomy followed by a colorectal anatomize at a time, twenty one patients of an intervention of Hartmann. A surgical distortion was realized at 3 patients. All the patients operated by these last two techniques had a restoring of the digestive continuity for an average deadline of 90 days. The post-operative complications consisted of 11 cases of parietal suppuration and a case of evisceration. The average duration of follow-up was of 210 days. The post-operative mortality was 14%. It was about a state of toxic shock with visceral multi-failure (n = 13), and of a pulmonary embolism (n = 1). The treatment of the volvulus requires a fast diagnostic and therapeutic coverage. The best treatment consists of a resection of the sigmoid as a matter of urgency followed by an immediate anastomosis if the following conditions are carried achieved: state general voucher, experimented surgeon and if the resuscitation meadow, per and post-operative can be assured.

关键词： Pelvic Colonist Volvulus Treatment Mopti Mali

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Epidemiological and Therapeutic Aspects of the Vaginal Hydroceles

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Surgical Science 2018年第12期9卷 474-479页

作者： Mamadou Alymami Keita Abdoulaye Kanté Drissa Ouattara Bréhima Bengaly Bréhima Coulibaly Drissa Traoré siaka diallo Babou Ba Djibril Traoré Mariam Daou Bakary Keita Birama Togola Nouhoum Ongoiba Service of Surgery B.CHU Point G.Bamako Mali Laboratory of Anatomy of the Faculty of Medicine and Odontostomatology BamakoMali Service of General Surgery Somine Dolo of Mopti hospitalBamakoMali Service of Neurology CHU Gabriel TouréBamakoMali Service of General Surgery Gabriel TouréBamakoMali

Purpose: Our purpose was to describe the epidemiological and therapeutic aspects of the vaginal hydroceles. Methodology: It was a forward-looking and descriptive study of Mars 2014 in July, 2017, which realized in the service of general surgery of the Reference Health Center of Kati (Mali). All the patients operated in the service for hydrocele were included. Other causes of big stock exchange and hydroceles operated outside our service were not including. Results: We operated 92 hydroceles or 5.9% of the surgical activities of the service. The average age was of 34.5 years with extremes of 2 years and 82 years. The most frequent signs of hydrocele were the big painless stock exchange (100%);a transillumination positive (90%) and the effusion of the vaginal in the ultrasound (100%). The cure of hydrocele was realized according to the techniques of Bergmann (94.6%) and of Lord (5.4%). The mortality was nil and the morbidity was 3.3% (2 operating infections of the site and 1 bruise). Conclusion: The hydrocele is a frequent pathology in Africa. The therapeutic strategies are multiple and varied. However, we prefer the Bergmann technique, which is easy, fast and has few complications.

关键词： Vaginal Hydrocele Surgery Bamako(Mali)

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