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Survival and Quality of Life of Patients after Rectal Cancer Surgery in a Low-Income Country: A Study in Cameroon, Sub-Saharan African Region

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Surgical Science 2021年第8期12卷 261-273页

作者： Guy Aristide Bang Eric Patrick Savom Georges Bwelle Moto Julienne Yambassa Fayam Yannick Mahamat Ekani Boukar Ousmana Oumarou Arthur Essomba maurice aurélien sosso Department of Surgery and Subspecialties Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Surgery Unit Yaoundé University Teaching Hospital Yaoundé Cameroon Surgery Unit Yaoundé General Hospital Yaoundé Cameroon Digestive Surgery Unit Yaoundé Central Hospital Yaoundé Cameroon

Background: Survival of patients after rectal cancer surgery as well as their quality of life (QoL) has been little studied in Africa and never in our country in particular. Methods: We conducted a cross-sectional multicentre study in Yaoundé (Cameroon). We reviewed operating reports of the selected departments to identify patients operated from January 2010 to December 2019 for a rectal cancer. The outcome of patients enrolled had to be known until December 2020. Patients who were alive were contacted to evaluate their QoL using the EORTC QLQ C30 (European Organization for Research and Treatment of Cancer QoL questionnaire). Results: During the study period, rectal cancer was ranked 4th within the digestive cancers. We included 68 patients;their mean age was 49.74 years and 41.18% were under 45. The sex ratio was 1.19 in favour of males. The tumour was mainly located in the lower rectum (45.6%). The main surgical procedure implemented was abdomino-perineal resection (42.6%). Forty-one patients died, giving a mortality rate of 60.29%. The mean survival time was 13 months. The 5-year survival rate for the 32 patients operated from January 2010 to December 2015 was 21.87%. The overall QoL of the 27 living patients was good with a mean of 62.346 ± 15.907. Sexual complications and urinary disorders were found in 40.74% and 14.81% of patients, respectively. Conclusion: There is a low hospital incidence of rectal cancer in our context. The 5-year survival after rectal cancer surgery is poor while the QoL of living patients is good.

关键词： Rectal Cancer Survival Quality of Life Cameroon

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

Contribution to Harmonic Depollution Control by the Use of Adaptive Hybrid Filter Type TLC: Case of Control by Modulated Hysteresis

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Energy and Power Engineering 2020年第10期12卷 578-602页

作者： Luc Vivien Assiene Mouodo Jean Gaston Tamba Olivier sosso Mayi Antoine Hanna Nohra Lawren Bibaya maurice Fadel Hadi Kanaan Laboratory of Modeling Materials and Methods of the National Higher Polytechnic School Douala University Douala Cameroon Institute of Technology Douala University Douala Cameroon Higher Normal School of Technical Education Douala University Douala Cameroon Faculty of Engineering—ESIB St-Joseph University Beirut Lebanon Université de Toulouse INPT UPS ENSEEIHT Toulouse France CNRS LAPLACE F-31071 Toulouse France School of Electrical and Electronic Engineering University Beijing China

In this article, we propose a topology of a TLC-HAPF power filter as a harmonic compensator for an optimization of the pollution control of electrical networks. This filter consists of an active part and a passive part in order to reduce or limit switching losses during current injection into networks thanks to its TLC module. This topology also provides solutions dynamic performance issues, resonance and lack of compensation capacity for imbalance cases. It also offers a greater range of compensation than conventional active models which do not offer as well as an intermediate circuit voltage in the order of 105 V to 109 V relatively lower than others models (600 v). A modulated hysteresis control of this topology is therefore also developed in this article and allows to obtain a network analysis on the three phases at three levels: source side, load side, and finally at the connection of the filter to the network, allowing to specify for these different positions the value of the current spectrum and its THD at this well-defined moment.

关键词： Hybrid Adaptive Active Filter Modulated Hysteresis THD Harmonic Pollution Control

Laparoscopic Radical Cystectomy in a Low-Middle Income Country: A 5-Year Review of a Single Institution;Operative Data, Oncologic Results and Morbidity

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Open Journal of Urology 2023年第11期13卷 484-494页

作者： Axel Stéphane Nwaha Makon Landry Oriol Mbouche Landry Tchuenkam Laure Kamkui Dadje Marcella Derboise Biyouma Bertin Nginkeu Njinou Pierre Joseph Fouda maurice aurelien sosso Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Urology Unit Department of Surgery Douala Laquintinie Hospital Douala Cameroon Department of Surgery Yaounde Gynaeco-Obstetric and Pediatric Hospital Yaounde Cameroon Bali Medical and Surgical Center of Urology (BMSCU) Douala Cameroon Yaounde Central Hospital Yaounde Cameroon

Introduction and Objective: Laparoscopic radical cystectomy (LRC) is an alternative to open approach with lower morbidity and better oncologic outcome. We aim to share our experience on laparoscopic radical cystectomy and to evaluate our morbidity and oncological outcome in our settings. Methodology: An observational study in the Douala Medico-Surgical Urology Centre on 5 patients who underwent laparoscopic cystectomy with or without lymph node dissection and external urine diversion between April 2014 to July 2016 was conducted. The overall survival rate was subsequently estimated. Results: Four men and one woman underwent laparoscopic radical cystectomy during the 5-year study period with a mean age of 54.5-year-old. Three patients were submitted to ileal conduits, one to neobladders, and one patient to uretero-cutaneostomies. The mean operative time was 300 ± 17 minutes and the mean length of hospital stay was 9 ± 3 days. Three patients had minor complications according to Clavien and Dindon Classification treated conservatively without need for further operation. Four patients had transitional cell carcinoma and one Squamous cell carcinoma types. Everyone had negative resection margin while only two had negative lymph node. The median survival years in our study was 2.5 years, the overall survival rates at 2 years were 60%, 40% at 3 years and 20 at 5years. 2 patients die after one year due to renal failure and intercurrent disease. Conclusion: Laparoscopic radical cystectomy carried lower morbidity and cancerological outcome compare to open surgery making it a good alternative for bladder oncologic surgery.

关键词： Radical Cystectomy Laparoscopy Oncology Findings Bladder Cancer

The Epidemiological Profil of Digestive Cancers in Secondary and Tertiary Health Care Facilities in Cameroon

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Surgical Science 2022年第3期13卷 98-104页

作者： Yannick Ekani Boukar Mahamat Georges Bwelle Cyrille Chopkeng Freddy Bombah Fabrice Tietche Tim Guy Aristide Bang Eric Patrick Savom Divine Mokake Alain Chichom Arthur Essomba Marcellin Ngowe maurice aurelien sosso Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon Digestive Surgery Unit Central Hospital of Yaounde Yaounde Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Cancers have been a major public health problem in developing countries in recent years. The aim of this study was to determine the epidemiological profile of digestive cancers in secondary and tertiary health care facilities in Cameroon. Methodology: This was a cross sectional and descriptive study conducted over a period of 12 months in 14 health structures over the national territory. Included in our study were patients aged 15 and above with a histologically proven digestive cancer, patients with a clinical, biological and morphologic evidence of a digestive cancer. Socio-demographic (age, gender, region of origin, profession), clinical (symptoms on diagnosis, personal and family past history, consumption habits, tumour location) and paraclinical data were recorded on a pretested questionnaire. Data was analysed using SPSS version 20.0. Quantitative data was expressed as means with their corresponding standard deviations. Chi square was used for correlation between variables. A P value 0.05 was considered statistically significant. Results: Five hundred and eighty-two cases of digestive cancers were recorded out of 37,780 consultations/admissions during the study period giving a prevalence of 1.5% with a male predominance (58.1%). The mean age was 53.11 ± 17.26 years (15 - 99) with 33.8% of them below 45 years of age. Tumours were predominantly localized in the liver (43.5%) and colon (24.9%). Adenocarcinoma was the most common histological type in 44.5% of all cases. Alcohol consumption was found to be associated with colorectal cancer (p = 0.028) while tobacco consumption was found to be significantly associated with oesophageal cancer (p ≤ 0.001) and gastric cancer (p = 0.0047). Conclusion: A third of patients with digestive cancers were aged less than 45 years suggesting an early onset of these cancers in our setting. Relatively low prevalence with the liver being the most common site of localisation in our setting.

关键词： Digestive Cancer Secondary and Tertiary Health Care Facilities Cameroon

Injury Patterns and Treatment Outcome of Road Traffic Crash Victims at the Emergency Department of the Regional Hospital Limbe, Cameroon

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Surgical Science 2022年第3期13卷 174-182页

作者： Mahamat Yannick Ekani Boukar Nana Teophile Chunteng Freddy Bombah Georges Bwelle Cyrille Chopkeng Guy Aristide Bang Eric Patrick Savom Divine Mokake Pius Fokam Alain Chichom Arthur Essomba Marcellin Ngowe maurice aurelien sosso Department of Surgery Faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Limbe Regional Hospital Limbe Cameroon Department of Surgery Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Surgery Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon

Background: Traumatic injuries constitute a leading cause of mortality and morbidity worldwide with a global burden that is on the rise. The aim of this study is to analyse preliminary data of the Limbe trauma registry, to describe the injury patterns and determine the outcome of care of the injured who were treated in the emergency department of the regional hospital Limbe in Cameroon. Methodology: This was a descriptive secondary analysis of prospective data collected on injury at Limbe Regional Hospital in two years, between October 2008 and October 2010. All cases of injury presenting to the emergency department of Limbe Regional Hospital were included in a prospective trauma registry. Data was collected with a pre-tested data entry form and included the age, sex, mechanism of injury, delay before arrival to hospital, body part injured, description of lesions and outcome at the emergency. Descriptive analyses were done using STATA 14. Comparisons between groups were evaluated using Chi-squared test or Kruskal-Wallis and p-values <0.05 were considered statistically significant. Results: A total of 2400 cases of injury were recorded during the study period with more males (68%) than females. The ages ranged from 0 to 90 years with a peak between 20 to 39 years. Road traffic crash was the most common cause of injury representing 60.81% of the population (n = 1434);other causes were burns, falls, domestic injuries, assaults, and labour accidents. The accidents mostly involved motor cycle alone (42.03%). Concerning the outcome of care at the emergency department, 88.73% (n = 1260) were discharged. Conclusion: The burden of road traffic injuries in south west Cameroon is high. Motorcycles are mostly involved alone or with pedestrians and/or cars.

关键词： Traumatic Injuries Limbe Regional Hospital Cameroon

Prevalence, Aetiology, and Clinical Profile of Acute Abdomen in Pregnancy in Southwest Cameroon: A 5-Year Retrospective Study

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Surgical Science 2023年第1期14卷 1-9页

作者： Yannick Mahamat Ekani Boukar Divine Mokake Felix Adolphe Elong Terence Dze Enah Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin Ngowe Ngowe maurice aurelien sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery Unit Buea Regional Hospital Buea Cameroon Gynaecology Unit Buea Regional Hospital Buea Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: Acute abdomen is one of the commonest reasons for presentation at the emergency department. The physiologic changes of pregnancy increase the chances of developing acute abdomen. The global incidence of acute abdomen in pregnancy range from 1 in 500 to 1 in 635 pregnant women. In 2018, a study in Azerbaijan reported a prevalence of 25%. However, to the best of our knowledge, very few studies have been carried out on this subject in Cameroon. Objectives: To determine the prevalence, assess the aetiologies, and review clinical profile of acute abdomen in pregnancy in the Southwest Cameroon. Methods: We conducted a 5-year retrospective study at the Obst/Gyn and Surgical units of Kumba, Buea, and Limbe Regional Hospitals. We included all files of pregnant women that were admitted for acute abdomen within the study period (1st Jan 2017 to 31st Dec 2021). Data was collected using a structured checklist adapted from previous studies. Descriptive statistics and statistical testing was done using SPSS version 25.0. Chi-square was used to compare categorical variables. p Results: Over 14,106 pregnant women were admitted to the aforementioned hospitals within the study period. 335 (2.4%) met our inclusion criteria. The patients’ age ranged from 17 to 43 years. The mean age was 27 years. Acute abdomen was more frequent (65%) in the first trimester. Ectopic pregnancy was the commonest obstetric aetiology while appendicitis was the commonest non obstetric surgical aetiology. Abdominal pain and tenderness were the most common presentation. Conclusion: The prevalence of acute abdomen in pregnancy in the Southwest Cameroon is 10 times higher than the global prevalence. Our study also confirmed the numerous aetiologies and varied clinical presentations of acute abdomen in pregnancy. Hence a wake-up call for primary care physicians.

关键词： Acute Abdomen Pregnancy Southwest Cameroon

Prevalence, Management and Outcomes of Enterocutaneous Fistulas in Buea Regional Hospital and Laquintinie Hospital of Douala. A Five Years Retrospective Study

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Surgical Science 2023年第1期14卷 17-29页

作者： Yannick Mahamat Ekani Boukar Divine Mokake Ousmana Oumarou Chimene Cecile Biiga II Moussa Adam Adami Eric Patrick Savom Anutebeh Verdo Zisuh Guy Aristide Bang Alain Chichom Mefire Arthur Essomba Marcellin Ngowe Ngowe maurice aurelien sosso Faculty of Health Sciences University of Buea Buea Cameroon Surgery unit Buea Regional Hospital Buea Cameroon Faculty of Medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of Human Health Sciences University of N’Djamena N’Djamena Tchad Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon

Background: An Enterocutaneous fistula (ECF) is an abnormal connection between the intestinal tracts or stomach and the skin. They are a major catastrophe to the patient and surgeons and still have a high incidence of morbidity and mortality which varies between 6% - 33%;their management remains a big challenge. These patients frequently face complications, and a well-organized multidisciplinary approach must be implemented in their management to improve outcomes. Objectives: Our study aims to assess the prevalence, management and outcomes of enterocutaneous fistulas in Buea regional hospital and Laquintinie hospital of Douala over the past 5 years. Methods: This was a hospital-based retrospective study in Buea regional hospital and Laquintinie hospital of Douala. Records of patients who had enterocutaneous fistulas within the period of 1st January 2017 to 31st December 2020 in the surgical departments. Data included demographics, pre-operative diagnosis, comorbidities, type of fistula, management modality and means, the indication of operative treatment, length of stay in the hospital and outcomes. Data was analysed using SPSSv26. Results: The study constituted 1343 medical records of which 83 medical records of patients with enterocutaneous fistulas, giving a prevalence of 6.2%, female predominance at 59% (n = 49), 42.2% (n = 35) were referred cases from the periphery for better management. A vast majority (96.4%) occurred as post-operative complications with appendectomy the most common indication (18.8%). High output fistulas were predominant (43.4%). 59% (n = 47) were managed medically, 6% (n = 5) received both conservative and surgical modalities while 35% (n = 5) were managed surgically. 64.1% (n = 50) were placed on enteral nutrition while 35.9% (n = 28) were placed on parenteral nutrition. Peritonitis/infection 50% (n = 18) was the commonest indication of surgical treatment, followed by failure of medical treatment 25% (n = 9) then hig

关键词： Enterocutaneous Fistula Prevalence Management Outcomes

Rib Osteosynthesis for Sub-Acute Management of a Flail Chest in a Tertiary Centre in a Low-Middle Income Country of Sub-Saharan Africa: Case Report at Douala Laquintinie Hospital

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Open Journal of Thoracic Surgery 2024年第1期14卷 1-16页

作者： Fabrice Stéphane Arroye Betou Nyankoue Mebouinz Ferdinand Guy Aristide Bang Kobe Folkabo Zephany Banga Nkomo Douglas Moussa Seck Diop Abdoul Lahad Mbeng Marcella Derboise Christelle Biyouma Noel Essomba Souleyman Diatta Handy Eone Daniel Arthur Essomba Hassan Ndiaye maurice aurelien sosso Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences (FMBS) University of Yaoundé (UYI) Yaoundé Cameroon Department of Surgery and Affiliated Disciplines Douala Laquintinie Hospital Douala Cameroon Department of Surgery and Specialties Yaoundé General Hospital Yaoundé Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences (FMPS) University of Dschang Dschang Cameroon Service de Chirurgie Thoracique et Cardiovasculaire Centre Hospitalier Universitaire de Fann Faculté de Médecine de Pharmacie et d’Odontologie Université de Cheikh Anta Diop Dakar Sénégal UFR des Sciences de la Santé Ziguinchor Sénégal

Background: Costal fracture surgical is still a debate, therefore we shall select between early and delay surgical management. Case Report: We are reporting two cases of post road traffic clash delay ribs fractures osteosynthesis involving a 63-year-old man with multistage fractures on the left and pulmonary pinning of one of the costal arches, complicated by a homolateral haemothorax and a 41-year-old man with a bilateral flail chest. Conclusion: The simple postoperative course and the immediate postoperative improvement in the patient’s clinical respiratory condition enabled us to discuss the time frame for management, in this case the indication for early or later surgery.

关键词： Flail Chest Fixation Plate Rib Fracture Osteosynthesis