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Transperitoneal Laparoscopic Nephrectomy for Non-Functional Kidneys: A Report of 25 Cases

Surgical Science 2022年第10期13卷 460-470页

作者： Cyril Kamadjou Emmanuel Muhawenimana innocent nzeyimana Achille Mbassi Bertin Njinou Ngninkeu Fru Angwafo Medico Surgical Center of Urology and Mini Invasive Surgery Douala Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Kigali University Teaching Hospital Kigali Rwanda Medical Technology Institute Yaounde Cameroon Gynaeco Obstetric and Pediatric Hospital Yaounde Cameroon

Background and Aim: Ever since the first-ever laparoscopic nephrectomy performed in 1991 by Clayman, laparoscopy has become the technique of choice for benign renal pathologies and also for cancerous lesions. In this paper, we present and evaluate the results of laparoscopic nephrectomy carried out on patients with non-functional kidneys at the Centre medico-chirugical d’urologie in Douala, Cameroon. Materials and Methods: This was a retrospective study carried out from 2016 to 2020. We included 25 patients with non-functional kidneys who underwent transperitoneal laparoscopic nephrectomy. Results: We included 25 patients (15 males and 10 females) with a mean age of 32.80 ± 9.76 years. Twenty (80%) patients presented with low back pain, four (16%) presented with acute pyelonephritis, and one (4%) presented with both low back pain and hematuria. The right kidney was damaged in 10 (40%) patients and the left kidney in 15 (60%) patients. The kidney failure requiring nephrectomy was due to stones in 16 (64%) patients and upper pyeloureteric junction obstruction in nine (36%) patients. The mean surgery duration was 111.08 ± 31.95 minutes. The median perioperative blood loss was 100 [70 - 120] ml. Percutaneous drainage was required in 13 (52%) patients. Only two (8%) patients developed postoperative complications. The mean follow-up duration was 64 ± 24.48 days. All patients survived the surgical intervention. Conclusion: Laparoscopic nephrectomy is a mini-invasive technique that is suitable for the surgical removal of non-functional kidneys due to either ureteropelvic junction obstruction or massive kidney stones.

关键词： Pelvic Calculi Laparoscopy Nephrectomy Pyeloureteric Junction Obstruction

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Sustainable strategies for Ebola virus disease outbreak preparedness in Africa:a case study on lessons learnt in countries neighbouring the Democratic Republic of the Congo

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Infectious Diseases of Poverty 2022年第6期11卷 60-69页

作者： Caroline S.Ryan Marie‑Roseline D.Belizaire Miriam Nanyunja Olushayo Oluseun Olu Yahaya Ali Ahmed Anderson Latt Matthew Tut Kol Bertrand Bamuleke Jayne Tusiime Nadia Nsabimbona Ishata Conteh Shamiso Nyashanu Patrick Otim Ramadan Solomon Fisseha Woldetsadik Jean‑Pierre Mulunda Nkata Jim T.Ntwari Senya D.nzeyimana Leopold Ouedraogo Georges Batona Vedaste Ndahindwa Elizabeth A.Mgamb Magdalene Armah Joseph Francis Wamala Argata Guracha Guyo Alex Yao Sokemawu Freeman Alexander Chimbaru innocent Komakech Muhau Kuku Walter M.Firmino Grace E.Saguti Faraja Msemwa Shikanga O‑Tipo Precious C.Kalubula Ngoy Nsenga Ambrose Otau Talisuna WHO Sub-Regional Ofce for Africa NairobiKenya WHO Country Ofce BanguiCentral African Republic WHO Country Ofce JubaSouth Sudan WHO Regional Ofce for Africa BrazzavilleCongo WHO Sub-Regional Ofce for Africa DakarSenegal Africa Centres for Disease Control and Prevention Addis AbabaEthiopia WHO Country Ofce BrazzavilleCongo WHO Coun‑try Ofce BujumburaBurundi WHO Country Ofce AsmaraEritrea WHO Country Ofce KigaliRwanda WHO Country Ofce KampalaUganda WHO Country Ofce LuandaAngola WHO Country Ofce Dar Es SalaamTanzania WHO Country Ofce LusakaZambia

Background: From May 2018 to September 2022, the Democratic Republic of Congo (DRC) experienced seven Ebola virus disease (EVD) outbreaks within its borders. During the 10th EVD outbreak (2018–2020), the largest experienced in the DRC and the second largest and most prolonged EVD outbreak recorded globally, a WHO risk assessment identified nine countries bordering the DRC as moderate to high risk from cross border importation. These countries implemented varying levels of Ebola virus disease preparedness interventions. This case study highlights the gains and shortfalls with the Ebola virus disease preparedness interventions within the various contexts of these countries against the background of a renewed and growing commitment for global epidemic preparedness highlighted during recent World Health Assembly *** text: Several positive impacts from preparedness support to countries bordering the affected provinces in the DRC were identified, including development of sustained capacities which were leveraged upon to respond to the subsequent coronavirus disease 2019 (COVID-19) pandemic. Shortfalls such as lost opportunities for operationalizing cross-border regional preparedness collaboration and better integration of multidisciplinary perspectives, vertical approaches to response pillars such as surveillance, over dependence on external support and duplication of efforts especially in areas of capacity building were also identified. A recurrent theme that emerged from this case study is the propensity towards implementing short-term interventions during active Ebola virus disease outbreaks for preparedness rather than sustainable investment into strengthening systems for improved health security in alignment with IHR obligations, the Sustainable Development Goals and advocating global policy for addressing the larger structural determinants underscoring these ***: Despite several international frameworks established at the global level for e

关键词： Ebola virus disease Emergency preparedness and response Lessons learned Case study International Health Regulations Democratic Republic of the Congo

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