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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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Acute Generalized Peritonitis in Intensive Care Unit at University Hospital of Brazzaville, Republic of Congo: Etiological, Therapeutic Aspects and Issues

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Open Journal of Emergency Medicine 2020年第4期8卷 86-94页

作者： Christ Mayick Mpoy Emy Monkessa Peggy Dahlia Gallou Leyono-Mawandza Marie Elombila Gilles Niengo Outsouta Marina Aurole Bokoba-Nde Ngala giresse bienvenu tsouassa wa ngono Gilbert Fabrice Otiobanda Polyvalent Intensive Care Unit University Hospital of Brazzaville Brazzaville Republic of Congo Anesthesia and Resuscitation Resident Cheikh Anta Diop University Dakar Senegal Faculty of Heath Sciences Marien N’Gouabi University Brazzaville Republic of Congo Anesthesia and Resuscitation Resident Cadi Ayyad University Marrakech Morocco Department of Visceral Surgery University Hospital of Brazzaville Brazzaville Republic of Congo

Aim: To determine etiological, therapeutic aspects and issues of AGP in intensive care unit (ICU) at University Hospital of Brazzaville (UHB). Materials and Methods: It was a retrospective and descriptive study carried out from January to December 2016 in ICU at UHB. We collected completed medical records of patients admitted and operated for AGP regardless of age or sex. The parameters studied were age, sex, admission’s reasons, etiologies, management, post-operative complications, length of hospital and mortality. Data were treated in Excel 2010 and Epi info 2007. Results: Thirty-one complete medical records were identified (mean age: 40.6 ± 22.0 years). The sex ratio was 2.4. Shock was the most common reason for admission with 67.7% of the cases. The etiologies of AGP were dominated by gastroduodenal perforating ulcer (41.9%) followed by complicated appendicitis (19.4%). The management of all patients was medico-surgical. The bi antibiotic ceftriaxone-metronidazole was administered in 29 patients (93.6%). 18 patients (59.1%) received vasopressor therapy. The complications had occurred among 9 patients i.e. 29% of the cases;parietal suppurations represented 44.5% of the complications. The average length of hospitalization was 5.2 ± 4.6 days. The overall mortality was 41.9%. Conclusion: In our study

关键词： Acute Generalized Peritonitis Brazzaville Etiologies Intensive Care Unit Issues

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Jaundice in the Newborn at the Teaching Hospital of Brazzaville

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Open Journal of Pediatrics 2019年第2期9卷 111-118页

作者： Gaston Ekouya Bowassa giresse tsouassa wa ngono Neli Yvette Ngakengni Engoba Moyen Koumou Onanga Steve Missambou Mandilou Georges Moyen Faculty of Health Sciences Marien NGOUABI University of Brazzaville Brazzaville Congo Department of Neonatology University Hospital of Brazzaville Brazzaville Congo Department of Biochimy University Hospital of Brazzaville Brazzaville Congo

Introduction: Jaundice is a major symptom during neonatal time. It is defined by a bilirubin ≥ 50 mg/l. Objectives: To determine the frequency of neonatal jaundice at the Brazzaville University Hospital, to determine the main etiologies, to evaluate the management, to specify the evolution. Patients and Method: It was a prospective and descriptive study that was conducted in the Neonatology Department and Biochemistry Laboratory of the University Hospital of Brazzaville, from 1st August 2015 to 31st July 2016. It included newborn children admitted into the neonatal unit for treatment of jaundice. The variables studied were epidemiological, clinical, etiological therapy and outcome. Results: The frequency of the neonatal jaundice is 7.2%. The hyperbilirubinemia as not conjugated was found in 99.1% of cases. The main causes are bacterial neonatal infection n = 102 (47.9%), the physiological icterus n = 46 (21.6%) and the ABO incompatibility n = 40 (18.8%). The treatment consists of the phototherapy in all cases. Each phototherapy session lasts 3 hours n = 99 (56.9%), 6 hours n = 58 (33.3%) and 12 hours n = 17 (9.8%). The average duration of the administering of the therapy is of 3 ± 2 days. Hyperbilirubinemia encephalopathy occurred in 62 (29.1%) cases, including 49 cases of kernicterus. The death occurred in 70 (32.9%) children. Conclusion: The importance and the gravity of the neonatal jaundice require primary preventive means based on proper care in pregnancy and the birth. While the secondary prevention includes high index of suspicion, comprehensive diagnostic equipment availability to prevent acute bilirubin encephalopathy.

关键词： Jaundice Neonatal Phototherapy Bilirubin Encephalopathy

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