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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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Extrasurrenal Pheochromocytoma: A Case Report and Review of the Literature

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Open Journal of Endocrine and Metabolic Diseases 2023年第8期13卷 137-142页

作者： Nestor Ghislain Andzouana Mbamognoua Roland Bertile Banga Mouss pierlesky elion ossibi Farel Ongoth Elilie Mawa Henri Germain Monabeka Department of Metabolic and Endocrine Diseases University Hospital of Brazzaville Brazzaville Republic of the Congo Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo Urology Department University Hospital of Brazzaville Brazzaville Republic of the Congo Digestive Surgery Department University Hospital of Brazzaville Brazzaville Republic of the Congo

Introduction: Pheochromocytoma is a rare cause of endocrine hypertension. We report the case of an extra-adrenal pheochromocytoma discovered in the setting of an abdominal mass. Observation: The patient was 25-year-old and presented with headaches, excessive sweating and palpitations, followed by a sensation of abdominal weightlessness and diastolic arterial hypertension. Abdominal computed tomography revealed a retroperitoneal, right para-renal extra-adrenal mass. In biology, an increase in urinary methoxylated derivatives at the expense of normetanephrine. Conclusion: Pheochromocytoma is a rare disease, diagnosed by measuring urinary or plasma methoxylated derivatives. Conventional or nuclear imaging allows topographic diagnosis. Genetic studies helps to identify other tumors.

关键词： Pheochromocytoma Arterial Hypertension Methoxylated Derivatives Genetics

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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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Adenocarcinoma of the Appendix

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Surgical Science 2018年第3期9卷 115-121页

作者： Moussa Sylla pierlesky elion ossibi Somuah Tenkorang Ismael Dandakoye KarimIbn Majdoub Imane Toughrai Said Ait Laalim Khalid Mazaz Department of Visceral Surgery B Hassan II University Hospital Fez Morocco Departement of Urology Hassan II University Hospital Fez Morocco

Objective: To report the experience of our department on adenocarcinoma of the appendix through a series of six (6) cases. Materials and Methods: This is a retrospective study carried out from January 2010 to June 2015 collating all cases of adenocarcinoma of the appendix diagnosed at the department of visceral surgery B in Hassan II University Hospital in Fez. Results: Six cases of adenocarcinoma of the appendix were recorded during the determined period of study. The mean age was 54.67 ± 16.99 years with the extreme ages ranging from 28 to 78 years. There was a female predominance with a sex ratio of 2. All patients had no specific medical history. The revealing symptoms were the following: appendicitis syndrome (1 case), bowel obstruction (1 case), psoas abscess (1 case) and fortuitous discovery during laparotomy for another problem (3 cases). The following histological types found were: colloid adenocarcinoma (3 cases), mucinous adenocarcinoma (2 case), mucinous cystadenocarcinoma associated with a moderately differentiated adenocarcinoma of the appendix (1 case). The surgical procedure consisted of a right hemicolectomy in 3 patients. Appendectomy followed by a right hemicolectomy and drainage of psoas abscess was performed in two patients. Palliative ileocecal resection and Bouilly-Volkmann ileocolostomy was performed in one patent who had carcinosis. All patients received adjuvant chemotherapy. The following occurred during follow-up: carcinosis (2 patients), a locoregional recurrence (2 patients). Two patients never returned for follow-up. Conclusion: Tumor of the appendix is a rare and exceptional pathology. These tumors are generally discovered fortuitously or during histology of appendectomy specimens. The treatment is usually surgical.

关键词： Adenocarcinoma Appendix

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Mixed Tumor of the Appendix: A Rare Tumor Association

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Surgical Science 2014年第10期5卷 483-486页

作者： pierlesky elion ossibi Mehdi Benkoukous Abdoul Aliou Zabeirou Oudou KarimIbn Majdoub Imane Toughrai Said AitLaalim Khalid Mazaz Visceral Surgery Department Hassan II University Hospital Fez Morocco

Malignant tumors of the appendix are rare. They are present in 0.1% to 0.5% of appendectomy specimens: confirmed upon histological analysis. Mixed tumors in the appendix are exceptional. We report a mixed mucinous cystadenoma with a moderately differentiated adenocarcinoma of the appendix in a 64-year-old patient presented to the emergency room with bowel obstruction syndrome.

关键词： Tumor Appendicitis Mixed

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Liposarcoma of the Spermatic Cord

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Case Reports in Clinical Medicine 2014年第9期3卷 518-520页

作者： pierlesky elion ossibi Hicham Anoune Khalid El Haoudi Karim Ibn Majdoub Imane Toughrai Said Ait Laalim Khalid Mazaz Visceral Surgery Department HASSAN II University Hospital Fez Morocco

Few cases of Liposarcoma of the spermatic cord have been reported in the literature. This rare tumor represents 7% of malignant tumors of the spermatic cord. We report a case of an unusual liposarcoma of the spermatic cord, with respect to its sclerosing variant, occurring in a healthy looking 42 years old man. A wide local excision of the tumor was performed. Adjuvant radiotherapy may sometimes be effective on local recurrence. Even though this tumor evolves slowly, a prolonged follow up is required because of the risk of late recurrence.

关键词： Liposarcoma Spermatic Cord Surgery

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Retroperitoneal Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP): Case Report

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Surgical Science 2016年第12期7卷 528-531页

作者： Moussa Sylla pierlesky elion ossibi Issam Yazough Eddy Oleko Ekuke El Bachir Benjelloun Said Ait Laalim Khalid Mazaz Khalid Ait Taleb Visceral Surgery Department Hassan II University Hospital Fez Morocco

Retro peritoneal smooth muscle tumors of uncertain malignant potential (STUMP) are rare and often misdiagnosed as leiomyosarcoma. We hereby report the case of a retroperitoneal STUMP diagnosed on a surgical specimen i... 详细信息

关键词： Smooth Muscle Tumors Uncertain Malignant Potential Retroperitoneal

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Pseudotumoral Colic Tuberculosis: A Rare Pathological Entity

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Surgical Science 2016年第12期7卷 522-527页

作者： Eddy Oleko Ekuke pierlesky elion ossibi El Mahdi Benkoukous Moussa Sylla Boubacar Efared Laila Chbani Abdelmalek Ousadden Khalid Mazaz Khalid Ait Taleb Visceral Surgery Department Hassan II University Hospital Fez Morocco Anatomy and Pathological Cytology Department Hassan II University Hospital Fez Morocco

Colic tuberculosis is rare even in countries endemic to Mycobacterium spp. Its incidence seems to be increasing over the last decade. Presentation in the form of abdominal mass is exceptional and often misdiagnosed as gastrointestinal tumor. The possibility of a colic involvement of this infection needs to be considered given the broad spectrum of clinical manifestations of TB infection. We present a case of pseudo colic tuberculosis in a 58-year-old patient with no history of disease.

关键词： Colon Tuberculosis Pseudo-Tumor

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Rupture of Liver Hydatid Cyst into Gall Bladder

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Surgical Science 2015年第7期6卷 301-303页

作者： El Mahdi Benkoukous pierlesky elion ossibi Hicham El Bouhadoutti Said Ait Laalim Abdelmalek Oussaden Khalid Mazaz Khalid Ait Taleb Department of Visceral Surgery Hassan II Teaching Hospital Fes Morocco

Hepatic hydatid cyst is a rare parasitic affection which constitutes a major health problem in countries endemic to hydatidosis. Rupture of hydatid cyst into gallbladder is an exceptional complication first described in 1952 by Atlas and Kamenear. We report the case of a hepatic hydatid cyst rupture into gallbladder in a 31-year-old patient with no history of disease.

关键词： Echinococcus granulosus Hydatid Cyst Gallbladder Rupture Complication

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