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Etiologies, Clinical Presentation and Outcome of Adult Patients Presenting with Bowel Obstruction on a Virgin Abdomen

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Surgical Science 2023年第3期14卷 252-269页

作者： Georges Bwelle Motto Tim Fabrice Yannick Mahamat Ekani Boukar El-Alaoui Mounjid Khadija Emmanuella joseph cyrille chopkeng Ngoumfe Arthur Essomba Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences The University of Yaounde 1 Yaounde Cameroon Departement of Visceral and Digestive Surgery Yaounde Central Hospital Yaounde Cameroon Departement of General Surgery Soa District Hospital Yaounde 2 Yaounde Cameroon

Context: Generally in Africa, BO remains the leading cause of acute abdomen. We therefore sought to study the current etiological factors of intestinal obstruction on a virgin abdomen or unhealed abdomen at the central hospital of Yaoundé in order to better understand the main causes and to better anticipate and improve the diagnosis, management and the evolution of intestinal obstruction on a virgin abdomen. Method: The patients were prospectively included from June 2021 to May 2022, these patients were recruited from the digestive and emergency surgery units of the Yaoundé Central Hospital during the study period and who met the inclusion criteria, with suspicion of partial or total intestinal obstruction or those with an intraoperative confirmed diagnosis were enrolled. Results: We recruited 73 patients including 43 (60.3%) men and 29 (39.7%) women whose mean age was 42.5 years with extremes ranging from 16 to 70 years. Most of them consulted after 72 hours, i.e. 65.2% of cases due to self-medication or even prior consultations in the lower level center at the Central Hospital of Yaoundé. The patients retained for this work presented in majority the symptoms according to the abdominal pains, the stop of the materials and gases;meteorism and vomiting. Abdominal wall hernias with incarcerated intestinal loops were the most common cause of intestinal obstruction in an unscarred abdomen in adults at 38.4% of cases, followed by digestive tumors 23.3% and adhesions 17.8%. Exceptionally, a cluster of roundworms was found as the cause of intestinal obstruction in two of our patients. Complications occurred in 25 patients or 31.5% of cases and were dominated respectively by nausea and hematoma (36%), local infections (24%) and malaria (24%). Death occurred in 5 of our patients, or 6.8% of cases, and was mostly caused by hypovolemic shock (40%) and pulmonary embolism (40%). Conclusion: Intestinal obstructions on the abdomen without scarring remain the prerogative of young

关键词： Acute Abdomen Intestinal Obstructions Etiologies

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Traumatic Rupture of the Diaphragm: Retrospective Study of 27 Cases Operated in Three Hospitals in Yaoundé (Cameroon)

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Surgical Science 2022年第4期13卷 207-215页

作者： Guy Aristide Bang Georges Bwele Motto Marie Ange Ngo Yamben Christel Teddy Chappi joseph cyrille chopkeng Daniel Biwole Biwole Bernadette Ngo Nonga Departement of Surgery Yaoundé University Teaching Hospital Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Department of Digestive Central Hospital of Yaoundé Yaoundé Cameroon Department of Orthopaedic Surgery and Traumatology Yaoundé Emergency Centre Yaoundé Cameroon

Background: Traumatic ruptures of the diaphragm (TRD) are serious lesions that are often part of polytrauma. They pose a real diagnostic and therapeutic challenge in a disadvantaged environment such as ours. Methods: We conducted a descriptive observational study covering a period of 11 years in 3 referral hospitals in the city of Yaoundé (Cameroon). All patients who had undergone surgery for a traumatic rupture of the diaphragm between January 1, 2011 and December 31, 2020, and whose outcome within 30 days of surgery was known were included. Results: A total of 27 patients were collected. Their mean age was 36.4 ± 19.7 years. There was a strong male predominance with 22 cases (81.5%). The TRD occurred mainly after an assault (n = 9, 33.3%), was mainly on the left side (n = 25, 92.6%) and was most often part of a polytrauma (n = 17, 62.9%). The lesions associated with TRD were mainly visceral (n = 11) and bony (n = 6). The diagnosis was made preoperatively in only 13 patients (48.1%). The average length of the diaphragmatic breach was 6.4 ± 4.5 cm and a simple suture was most often used for the repair (26 cases or 96.3%). Four osteosynthesis procedures were performed at the same time as the diaphragmatic repair. The morbidity rate was 51.9%, with surgical site infection as the main complication. Six deaths (22.2%) were recorded;septic shock was the main etiology (n = 4). Conclusion: The hospital incidence of TRD remains low in our context. These lesions remain associated with significant morbidity and mortality and require a multidisciplinary approach.

关键词： Traumatic Rupture of the Diaphragm Morbidity Mortality Polytrauma

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Internal Lateral Sphincterotomy in Yaounde: Comparative Short-Term Results of Open versus Closed Techniques

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Surgical Science 2021年第11期12卷 374-380页

作者： Georges Bwelle Motto Yannick Mahamat Ekani Boukar Guy Aristide Bang joseph cyrille chopkeng Ngoumfe Fabrice Tientcheu Tim Arthur Essomba Maurice Aurélien Sosso Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaounde Cameroon Department of Visceral and Digestive Surgery Yaoundé Central Hospital Yaounde Cameroon Department of Surgery University of Buea Buea Cameroon

Background: Chronic anal fissure is a benign disorder which is associated with considerable discomfort. Aim of the Work: The aim of this study was to compare the post-operative results of open and closed internal lateral sphincterotomies in the short and medium term. Patient and Methods: We carried out a prospective randomized comparative study in the digestive and visceral surgery departments of Central Hospital of Yaounde over a period of 15 months. Patients were evaluated for each technique by several variables, including duration of surgery, post-operative pain, recurrence, surgical wound infection, gas and/or stool incontinence, and healing time with follow-up up to 12 months postoperatively. Results: A total of 63 patients underwent surgery within them we had 32 open lateral internal sphincterotomies (group

关键词： Anal Fissure Internal Lateral Sphincterotomy Open Technique Close Technique

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Ligation of the Intersphincteric Fistula Traject with Placement of a Prosthesis: A New Technique in the Treatment of Fistula-in-Ano at Yaounde Central Hospital (Cameroon)

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Surgical Science 2022年第2期13卷 66-77页

作者： Eric Patrick Savom Georges Roger Bwelle Motto Guy Aristide Bang joseph cyrille chopkeng Ricardo Fomene Ngouanet Ghislain Loïc Batimba Nolabia Arthur Essomba Yaounde General Hospital Yaounde Cameroon Faculty of Medicine and Biomedical Sciences of the University of Yaounde I Yaounde Cameroon Yaounde Central Hospital Yaounde Cameroon Yaounde Hospital and Teaching Centre Yaounde Cameroon Higher Institute of Medical Technologies of Yaounde Yaounde Cameroon

Background: Ligation of the inter-sphincter fistula tract associated with anal plug (LIFT-Plug) is a new anal fistula treatment procedure at the Yaoundé Central Hospital. A two-sided prosthesis piece bent in the shape of a cone is used here as an anal plug. The aim of this work was to evaluate the therapeutic results and the safety of this device. Patients and Methods: The clinical data of patients operated by the LIFT-Plug technique from January 1, 2020 to June 30, 2021 for a high anal fistula were analyzed prospectively. The variables evaluated were operative time, cure rate, postoperative complications and recurrence rate. Results: We included 28 patients with a mean age of 42 years. The sex ratio was 1.15. No patient presented preoperative continence disorder. The fistula was high trans-sphincteric in 89.3% of cases. The average duration of surgery was 55.2 minutes (45 to 66 minutes). The postoperative course was straightforward, although 60.7% of the patients had experienced tingling that resolved spontaneously. Three patients (10.7%) presented with transient gas incontinence (WIS of 4) which completely resolved after one month. All patients healed within a mean of 63.21 days (25 to 95 days). At the end of the 6-month follow-up, no case of recurrence had been recorded. Conclusion: The LIFT-Plug is a simple, safe and effective technique for the treatment of upper anal fistula without major impairment of continence despite delayed healing. The adapted two-sided prosthesis is a good alternative to the conventional anal plug.

关键词： High Anal Fistula LIFT-Plug Healing Postoperative Complications Recurrence

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Emergency Digestive Oncological Surgery in Yaounde (Cameroon): Indications and Short-Term Results

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Surgical Science 2022年第4期13卷 198-206页

作者： Guy Aristide Bang Goura a Goura joseph cyrille chopkeng Eric Patrick Savom Yanick Mahamat Ekani Boukar Daniel Biwole Biwole Amanda Missi Bernadette Ngo Nonga Department of Surgery Yaoundé Hospital and Teaching Center Yaoundé Cameroon Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Regional Hospital Limbe Limbe Cameroon Surgical Department Yaounde General Hospital Yaoundé Cameroon Surgical Department Yaounde Emergency Centre Yaoundé Cameroon Radiology Department Yaounde University Hospital Yaoundé Cameroon

Background: Data on emergency digestive oncology surgery are limited in Cameroon. The aim of this work was to give the short-term results of emergency digestive carcinological surgery in our context. Patients and Methods: We conducted a descriptive and analytical observational study with retrospective data collection in four reference hospitals in the city of Yaoundé. Files of patients who had emergency digestive oncological surgery, for an acute complication, from January 1, 2016 to December 31, 2020, were included. The outcomes of the patients in the 30 days following the surgery had to be known. Results: We collected 41 patients, representing 20% of the digestive oncological surgery activity. Their average age was 51.76 ± 16.59 years with a male predominance (63.4%). The cancer complication was inaugural in 27 patients. The main tumor sites were colic (56.1%), rectal (19.5%), and gastric (9.7%). The indications for surgery were: acute bowel obstruction (60.9%), acute generalized peritonitis (29.3%), and gastrointestinal bleeding (4.9%). The tumor was diagnosed intraoperatively in 10 patients (24.4%). The main operative procedures were left colectomy (21.9%) and Hartmann’s intervention (19.5%). The morbidity and mortality rates were 60.9% and 43.9%, respectively. Preoperative anemia (p = 0.019), peritonitis as indication for surgery (p = 0.039) and TNM stage 4 (p = 0.015) were identified as associated with an increased risk of death. Conclusion: In our context, one-fifth of digestive oncological surgery is done urgently in front of an acute complication which is inaugural for cancer in nearly two-thirds of patients. Postoperative morbidity and mortality are significant.

关键词： Digestive cancer Emergency Acute abdomen Oncological Surgery Cameroon

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Outcomes and Quality of Life of Patients with a Digestive Stoma in Sub-Saharan Africa: Case of the Yaounde Central Hospital, Cameroon

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Surgical Science 2021年第11期12卷 381-389页

作者： Georges Bwelle Motto Guy Aristide Bang joseph cyrille chopkeng Ngoumfe Yannick Mahamat Ekani Boukar Raissa Larissa Kom de Sendjong Bernadette Ngo Nonga Maurice Aurélien Sosso Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences The University of Yaoundé I Yaoundé Cameroon Department of Visceral and Digestive Surgery Yaoundé Central Hospital Yaoundé Cameroon Department of Surgery University of Buea Buea Cameroon

Introduction: The installation of a digestive stoma involves changes affecting all aspects of the patients’ lives. The objective of this study was to determine the impact of a digestive stoma on the quality of life of patients operated on at the Yaounde Central Hospital (YCH). Patients and Methodology: We conducted a prospective descriptive study over a period of 12 months from June 2018 to May 2019 in all patients with a digestive stoma for at least 3 months operated on at the YCH. The follow-up was done within 12 months. Quality of life was assessed using the stoma QOL (quality of life) and self-image using the BIS (Body Image Scale). Results: We collected a total of 34 patients, of whom 22 were male, giving an M/F sex ratio of 1.8. The average age of the patients was 42.8 years. The indications were tumoral in 44.11% of cases (n = 15) and non-tumoral in 55.88% of cases (n = 19). The colon was the most frequently ablated organ (n

关键词： Stoma Quality of Life Self-Image Cameroon

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Etiologies, Clinical Presentation and Outcome of Adult Patients Presenting with Bowel Obstruction on a Virgin Abdomen

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Surgical Science 2023年第3期

作者： Georges Bwelle Motto Tim Fabrice Yannick Mahamat Ekani Boukar El-Alaoui Mounjid Khadija Emmanuella joseph cyrille chopkeng Ngoumfe Arthur Essomba

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Refinement of Bouguer anomalies derived from the EGM2008 model,impact on gravimetric signatures in mountainous region:Case of Cameroon Volcanic Line,Central Africa

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Earth and Planetary Physics 2020年第6期4卷 639-650页

作者： Paul Gautier Kamto cyrille Mezoue Adiang Severin Nguiya joseph Kamguia Loudi Yap Geodesy Research Laboratory National Institute of Cartography(NIC)YaoundeCameroon Department of Physics Faculty of ScienceUniversity of Yaounde ICameroon Laboratory E3M Faculty of Industrial EngineeringUniversity of DoualaCameroon Department of Physics Faculty of ScienceUniversity of DoualaCameroon

Global geopotential models have not included the very high frequencies of the Earth’s external gravity *** is called omission *** omission error becomes more important in mountainous areas(areas with highly variable topography).The work reported here consists in reducing the omission error in measurements of Bouguer gravity anomalies,by refining the global geopotential model EGM2008 using the spectral enhancement *** method consists in computing the residual terrain effects and then coupling them to the gravimetric signal of the global geopotential *** compute the residual terrain effects,we used the Residual Terrain Model(RTM)*** refine it required a reference surface(ETOPO1)developed up to degree 2190(the maximum degree of the EGM2008 model)and a detailed elevation model(AW3D30).Computation was performed with the TC program of the GRAVSOFT *** topography of the study area was assumed to have a constant density of 2670 kg/*** the inner and outer zones,the respective integration radii of 10 km and 200 km have been *** obtained very important RTM values ranging from−53.59 to 34.79 *** values were added to the gravity anomalies grid of the EGM2008 model to improve accuracy at high *** a part of the Cameroon Volcanic Line and its surroundings(mountainous area),we made a comparison between the residual Bouguer anomalies before and after *** report differences ranging from−37.40 to 26.40 *** conclude that the impact of omission error on gravimetric signatures is observed especially in areas with high variable topography,such as on the Cameroon Volcanic Line and around the localities of Takamanda,Essu,Dumbo,and *** finding illustrates the great influence that topography has on accurate measurement of these gravity anomalies,and thus why topography must be taken into *** can conclude that in preparing a global geopotential model,a high resolution DTM must be used to decrease

关键词： residual Terrain Model EGM2008 Omission error refined Bouguer anomalies mountainous area

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Persistent X-ray-activated phosphors:mechanisms and applications

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Light(Science & Applications) 2022年第6期11卷 1008-1010页

作者： cyrille Richard Bruno Viana UniversitéParis Cité CNRSINSERMUTCBSUnitéde Technologies Chimiques et Biologiques pour la SantéFacultéde Pharmacie75006 ParisFrance IRCP CNRS UMR8247PSL UniversityChimie ParisTech11 Rue P&M Curie75005 ParisFrance

Trivalent lanthanides in wide bandgap fluoride or phosphate hosts can present persistent luminescence between 200 nm and 1.7 μm after charging by *** are reviewed and applications envisioned.

关键词： lanthanide fluoride luminescence

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Towards a trait-based quantification of species niche

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Journal of Plant Ecology 2009年第2期2卷 87-93页

作者： cyrille Violle Lin Jiang School of Biology Georgia Institute of Technology310 Ferst DriveAtlantaGA 30332USA

Aims Although the niche concept is of prime importance in ecology,the quantification of plant species’niches remains *** we propose that plant functional traits,as determinants of species performance,may be useful tools for quantifying species niche parameters over environmental *** findings Under this framework,the mean trait values of a species determine its niche position along gradients,and intraspecific trait variability determines its niche *** trait-based approach can provide an operational assessment of niche for a potentially large number of species,making it possible to understand and predict species niche shifts under environmental *** further advocate a promising method that recently appeared in the literature,which partitions trait diversity into among-and within-community components as a way to quantify the species niche in units of traits instead of environmental *** approach allows the switch of the focus from ecological niches to trait niches,facilitating the examination of species coexistence along undefined environmental ***,the trait-based approach provides a promising toolkit for quantifying the species ecological niche and for understanding the evolution of species niche and traits.

关键词： functional diversity plant functional traits niche breadth niche position trait niche

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