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Volvulus of the Sigmoid Colon—Management in the Surgery “A” Department of the Teaching Hospital of Point G

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Surgical Science 2020年第12期11卷 469-478页

作者： Sidiki Keita Koniba Keita Moussa Sissoko Mahamadou Coulibaly Lamine Soumare oumar Sacko Sekou Koumare Adama K. Koita Soumaîla Keita Zimogo Zié sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: The volvulus of the sigmoid colon is the twist of the sigmoid handle on its mesocolic axis, achieving a low occlusion by strangulation. Methodology: The study was conducted in the surgery “A” department of the Teaching Hospital of Point G in Bamako. The study is retrospective and descriptive, over 5 years, ranging from January 2014 to December 2018. We conducted a comprehensive recruitment of all patients operated on for sigmoid volvulus during the study period. The only criterion for inclusion was patients operated on for volvulus of the sigmoid colon in the surgery “A” department of the Point G Hospital and the non-inclusion criteria were all patients operated on for other sigmoid pathologies without volvulation and patients operated on for other types of occlusions. Result: We conducted an exhaustive recruitment of 55 patients operated on for sigmoid volvulus during the study period. Sigmoid volvulus accounted for 13.75% of intestinal obstructions. The average age of patients was 48.013 ± 18.042 years with extremes of 24 years and 82 years. The age group 40 - 49 was the most represented at 21.8%. The sex ratio (M/F) was 8 in favour of male sex. The duration of the disease was less than 1-day in 50.94% of patients. There were two cases of ileo-sigmoid nodes. Immediate anastomosis resection was performed in 27 patients or 49.2% of cases. The time to restore continuity when specified was between 60 - 90 days and the median incision was the most common route of recovery at 80.8% of cases. The average length of hospitalization was 9 days with extremes of 2 days and 42 days. The morbidity rate was 7.3%. In our study we had 3 deaths or 5.5% of the cases. Conclusion: The volvulus of the sigmoid colon is the twist of the sigmoid handle on its mesocolic axis, achieving a low occlusion by strangulation. The volvulus of sigmoid is a serious surgical emergency that requires early diagnosis and m

关键词： Volvulus Sigmoid Sigmoidectomy Hartmann Bouilly-Volkmann Anastomosis

Experience of the Department of Surgery “A” Point-G Hospital in the Management of Hemorrhoids (Mali)

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Surgical Science 2020年第12期11卷 435-445页

作者： Sidiki Keita Koniba Keita Mahamadou Coulibaly Lamine Soumare Moussa Sissoko oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Hemorrhoidal disease is the most common condition in proctology: it is defined by signs or symptoms attributed to hemorrhoids. There is no parallel between the extent of hemorrhoidal anatomical disease and the symptoms described by patients. Our objective was to assess the incidence of hemorrhoidal disease, to diagnose it and to propose therapeutics. Patients and Method: This was a prospective and descriptive study based on a pre-established protocol that had taken place over a 12-month period. All patients (92 cases) underwent a general examination and a proctological examination. Anoscopy has often been associated with rectoscope with or without biopsy of the rectal mucosa. The inclusion criteria were the finding of hemorrhoidal disease, associated or not with other proctological diseases and the criteria for non-inclusion was any other anorectal pathology. Results: Among our patients there were 69 men or 75% of cases and 23 women or 25% of cases. The sex ratio was 3 in favor of men, the average age was 35.42. The duration of progression of the disease was between 0 - 2 years in 59.78%. Constipation (60 cases or 66.3%) and diarrhea (60 cases or 22.8%) were the factors that triggered the disease. Hemorrhoids with 3 packets were the most common (49 cases or 53.26%). 56 patients were treated medically and 36 patients were operated on. The surgical technique was simple hemorrhoidectomy according to MILLIGAN and MORGAN. It was associated with a fissurectomy in 8.33% of cases, a fistulectomy in 13.90% of cases or a thrombectomy in 33.33%. Early surgical sequels were dominated by pain in all patients, rectorragie, and urine retention. We did not deplore any deaths. Conclusion: Hemorrhoidal disease is an anatomoclinical entity that is still poorly elucidated and no direct link between the nature of the lesions and symptomatology can be established.

关键词： Proctology Hemorrhoids Management

Post-Operatory Acute Eviscerations in Teaching Hospitals of Bamako (Mali)

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Surgical Science 2020年第12期11卷 428-434页

作者： Sidiki Keita Koniba Keita Lamine Soumaré Moussa Sissoko Mahamadou Coulibaly oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Post-operative acute evisceration is defined as a total dehiscence of the abdominal wall of all the constituents of the abdominal wall. The objective is to determine hospital frequency, identify favorable factors and key etiologies, and assess the rate of morbi-mortality. Patients and Method: This is a retrospective and descriptive study carried out in the general surgery departments of the Teaching Hospitals of Point “G”, Gabriel TOURE and the pediatric surgery department of the Gabriel TOURE University Hospital in Bamako, involving 53 patients. The study ran from January 1, 2005 to December 31, 2007. Inclusion Criteria: All cases of postoperative acute evisceration operated. Non-Inclusion Criteria: All cases of evisceration of other etiologies. Results: The average age was 34.2 years with extremes of 6 and 75 years, the sex ratio was 1.12 in favor of women. The initial clinical picture was peritonitis in 26 cases or 49.1%, occlusion in 16 cases or 30.2% and tumors in 6 cases or 11.3%. The post-operative complications responsible for evisceration were: parietal suppuration 28 cases or 52.8%;digestive fistulas 15 cases or 28.3%;post-operative ascites 4 cases or 7.5%. Conclusion: Post-operative acute evisceration is a rare but serious condition due to morbidity and mortality.

关键词： Post-Operatory Acute Eviscerations Teaching Hospitals Mali

Stomach Cancer: Surgical Management and Impact of Lymph Node Dissection in Survival at the Surgery “A” Department of the National Hospital of Point “G” (Mali)

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Surgical Science 2020年第12期11卷 458-468页

作者： Sidiki Keita Koniba Keita Moussa Sissoko Mahamadou Coulibaly Lamine Soumare oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita Zimogo Zié sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Although its incidence has tended to decrease for several years, stomach cancer remains one of the most frequently diagnosed cancers worldwide. Globally, gastric cancer is the 4th most common cancer in men, the 5th in women, and the third leading cause of cancer death in men, the 5th in women. Patients and Methods: This was an analytical, prospective and descriptive study. Study Framework: Our study took place in the “A” surgery department of the Point “G” Hospital in Bamako. Study Period: August 1, 2003 to August 31, 2005. The design and preparation phase of the fact sheet lasted 1 month. The data collection phase lasted 18 months. All the patients who consulted for gastric tumor had a record. The follow-up phase of the patients lasted 6 months during which the patients were followed by appointment, by contact person or seen at home. Data entry and analysis were conducted with Epi-Info software (version 6.0). Inclusion Criteria: All patients hospitalized for gastric cancer in the “A” surgery department of the Point “G” Hospital. Result: The distribution of patients according to the evolutionary stage TNM was: Stage IV (50 cases, or 64.94%);Stage III (21 cases, or 27.27%);Stage II (6 cases, or 7.79%). In our series the average age was 59 with extremes of 20 to 85 years. The most represented age group was 46 - 65 years. Men were 60 cases (77.90%) 17 cases for women (22.10%). The sex ratio was 3.53 in favor of men. All 77 patients were recruited during the outpatient clinic, including 55 patients referred by a physician and 20 patients who came by themselves. Esogastroduodenal fibroscopy was performed in all of our patients. The tumor was localized: to the cardia in 10 cases;cardiac fundus in 2 cases;antrum in 24 cases;antro-pyloric in 28 cases;Pylorus in 1 case;great curvature in 5 cases;small curvature in 2 cases. Posto

关键词： Cancer Stomach Resectability Lymph Node Dissection Survival

Evaluation of the Quality of Prenatal Consultation in Rural Area of Mali, Case of Kadiolo Health District

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Open Journal of Clinical Diagnostics 2020年第1期10卷 49-64页

作者： Fane Seydou Sissoko Abdoulaye Kanté Ibrahima Bocoum Amadou Sima Mamadou sanogo Abdoulaye Traore Soumana oumar sanogo Siaka Amara Traore Mamadou Salia Traore Alassane Saleck Doumbia Mamadou Keita Salem Yargueit Traore Youssouf Tegueté Ibrahima Mounkoro Niani Gynecology-Obstetrics Service University Teaching Hospital Gabriel Touré Bamako Mali Hospital Mother-Child the Luxembourg Bamako Mali University Teaching Hospital of Point G Bamako Mali Referral Health Center of Kadiolo Bamako Mali Referral Health Center of Commune V Bamako Mali Hospital of Mali Bamako Mali Referral Health Center of Commune VI Bamako Mali

Every woman has the right to receive satisfactory quality prenatal care in reproductive health. Giving a life while remaining alive and without sequelae must be the slogan of any gynecologist - obstetrician and midwife, as well as any health worker. It was a descriptive cross-sectional study dealing with the evaluation of the quality of prenatal consultations at the Kadiolo referral health center (or RHC). Adevis Donabedian’s model for assessing the quality of care and services served as a benchmark. According to Donabedian quality means good technical care, with good interpersonal relationships, and adequate and comfortable premises. This study took place from April 24 to December 04, 2017 and aimed to assess the current level of the quality of prenatal consultations at the Kadiolo referral health center, to study the structures in place including infrastructure and personnel, to specify the procedures and to determine their results. This work has permitted us to classify the RHC of Kadiolo at level III with 85%, which means that the references evaluated were satisfactory, with the level of 75% to 94%. In terms of structure, a pricing system was deemed affordable by the opinion of pregnant women. The analysis of the level of the human dimension revealed that the health center was level III. The pregnant women were satisfied with the reception which was good in 76% of the cases, as well as with the quality of the respect of the privacy in 96% and confidentiality in 95%. Despite the satisfaction of pregnant women, gaps remain to be filled in concerning the quality of the services received at the Kadiolo referral health center so as to reach level IV.

关键词： Pregnancy Prenatal Consultation Quality of Care and Services Risk Factors Kadiolo Referral Health Center Mali

Study of Cofactors Associated with Precancerous High-Grade Cervical Lesions at the Teaching Hospital Gabriel Touré, 2010 to 2015

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Surgical Science 2019年第9期10卷 328-337页

作者： Fané Seydou Bocoum Amadou Sissoko Abdoulaye Traoré Soumana oumar sanogo Siaka Amara Mamadou Sima Kouma Aminata Traoré Alassane Tegueté Ibrahima Traoré Youssouf Mounkoro Niani Teaching Hospital Gabriel Toure Bamako Mali

Introduction: High grade dysplasia of the cervix has a high incidence and can progress to cervical cancer. The aim was to study cofactors associated with high-grade cervical dysplasia. Methodology: This was a retrospective case-control study without matching. Women with high grade dysplasia were the cases while those with a normal screening test represented the controls. The study took place at the Gabriel Touré University Hospital Center in Bamako. We included 351 cases and 420 controls. The capture and analysis were performed using the SPSS 20 software. A univariate and multivariate logistic regression analysis was performed for the analysis of risk cofactors. The statistical tests used were the odds ratio and its confidence interval and the statistical significance threshold was set at p Results: In univariate analysis, the co-factors statistically significantly associated with the occurrence of high-grade dysplasia were parity 0.6 (0.5 - 0.9), gestational 0.7 (0.5 - 0.9), smoking of the spouse 3.4 (1.1 - 11.3), the non-schooling 1.4 (1.2 - 2.1). In multivariate analysis after adjusting for confounding factors, two co-factors have significantly increased the risk of high-grade dysplasia: lack of schooling 1.4 (1.2 - 2.0) and polygamy 1.5 (1.4 - 2.5). Conclusion: At the end of this study, polygamy and lack of schooling were the main risk factors. The prevention of cervical cancer will go through the education of girls and women as well as communication for behavioral change and social change.

关键词： High Grade Dysplasia Cofactor Cervical Cancer Teaching Hospital Gabriel Touré

Feasibility of Scanopelvimetry in the Medical Imaging Department of the University Hospital of Point “G”.

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Open Journal of Medical Imaging 2022年第3期12卷 157-164页

作者： Abdoulaye Koné Moussa Konaté Youssouf Koné Moussa Traore Youssouf Diawara Ibrahima Coulibaly Ouncoumba Diarra Fatoumata Kalapo Amadou Doumbia Kassim Sidibe cheick oumar Touré oumar Aba Ata Mody A. Camara Mamadou Sima Coulibaly Salia Mahamadou Diallo Adama Diaman Keita Siaka Sidibé Faculty of Medicine and Odontostomatology Bamako Mali Medical Imaging Department of the University Hospital of Point G Bamako Mali Radiology Department of the Jacques Boutard Hospital Saint-Yrieix-la-Perche France Medical Imaging Department of GABRIEL TOURE Hospital Bamako Mali Radiology Department of CSREF Commune III Bamako Mali Medical Imaging Service Health Center of Ref Commune VI Bamako Mali DCSSA Kati Mali Medical Imaging Service Health Center of Ref Commune IV Bamako Mali Medical Imaging Service of the Mali Hospital Bamako Mali. Surgery of Gynecology-Obstetrics CHU Point G Bamako Mali Medical Imaging Department CHU BSS Kati Mali

Purpose: The purpose of our study was to describe the technique of scanopelvimetry used in the radiology department of the Point G University Hospital, to specify the indications of scanopelvimetry in the department and to evaluate the cost of radiopelvimetry. Patients and Method: This was a prospective, cross-sectional study that took place over a 12-month period from January 1 to December 31, 2018. It focused on pregnant women in whom scanopelvimetry was performed in the medical imaging department of Point G University Hospital during the study period. Results: Out of 8615 CT examinations performed in the radiology department, we collected 65 cases of scanopelvimetry, i.e., 0.7% of the CT examinations. Primigravida and paucigravida dominated the study (40% each). In 60% of the pregnant women the height was less than 150 cm. The most frequent indication for CT scanning was clinical pelvic narrowing (50%). In 80% of the cases, the scanopelvimetry was performed after 37 weeks of amenorrhea. A predominance of narrowing of the superior strait was noted (40%). 4.6% of the pregnant women had a Magnin index of less than 20. CT scanopelvimetry is a feasible examination in our context but the level of demand is low because of the high cost of the examination (49500 fca). Conclusion: In light of the results obtained, we can say that CT pelvimetry allows us to predict the probable route of delivery and thus we can reduce the risk of fetomaternal morbidity and mortality to improve maternal and child health.

关键词： Scanopelvimetry Prognosis Magnin Index Delivery

Larynx Cancer: Review of 11 Years of Activity in the ENT and Head and Neck Surgery Department of University Hospital Gabriel Toure, Bamako

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第4期11卷 193-201页

作者： Diarra Kassim Konate Nfaly sanogo Harouna Katile oumar Dembele Yaya Soumaoro Siaka Guindo Boubacary Cisse Naoma Coulibaly Kalifa Kone Fatogoma Issa Doumbia Kadidiatou Keita Mohamed Amadou ENT and Head and Neck Surgery Department Gabriel Toure Bamako Mali ENT and Head and Neck Surgery Department Reference Health Kalanbancoro Bamako Mali Army Polyclinic Kati Bamako Mali

Objectives: To study the epidemio-clinical, therapeutic and evolutionary aspects of laryngeal cancers in the ENT department of the University Hospital Gabriel Toure. Materials and Methods: This was a descriptive, retrospective study over a period of 11 years from January 2008 to December 2019. We made an exhaustive sampling of all cases of malignant tumors of the larynx in the ENT department of the University Hospital Gabriel TOURE. Variables studied: frequency, sex, age, clinic, imaging, histology, TNM classification, treatment received and follow-up time was 1 to 11 years. Result: we noted a male predominance (44 men/13 women). The average age was 52.23 years, with extremes of 32 and 74 years. Smoking was reported by 40 patients (72% of cases). The average in pack-years is 29.32 with extremes of 4 to 60 packs/ year. Alcoholism was reported by 6 patients (9% of cases). Squamous cell carcinoma was the predominant histological type (100%);extension to 2 or 3 floors was objectified in 69% of cases. Complementary radiotherapy in 26 patients after total laryngectomy. Chemotherapy was done in a neoadjuvant situation in 36 cases. Overall survival was: 52.6% at 1 year, 33.3% at 3 years;26.3% at 5 years and 12.28% at 11 years. Conclusion: Most often, late diagnosis is due to the absence of a national strategy and the underestimation of the first symptoms. Surgery coupled with radiotherapy is the treatment of choice.

关键词： Laryngeal Cancer Histology Treatment Follow-Up

Epidemiological and Clinical Study of Cardiac Diseases in the Pediatric Department of the University Hospital Gabriel Touré(UH GT), Bamako (Mali)

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World Journal of Cardiovascular Diseases 2018年第7期8卷 328-336页

作者： Maiga Belco Ba Hamidou oumar Sacko Karamoko Dembélé Adama sanogo Nouhoum Cissé Mohamed Elmouloud Togo Pierre Diakité Abdoul Aziz Dicko-Traoré Fatoumata Sylla Mariam Pediatric Department UH GT Bamako Mali Cardiology UH GT Bamako Mali

Introduction: Children’s heart disease is a major public health problem in developing countries and especially in Mali. The purpose of our work was to determine frequency, different types of heart disease and their short term evolution in the pediatric department. Methods: We performed a retrospective study among children aged 0 to 15 years, hospitalized in the pediatric department from January to December 2015 and whose diagnosis was confirmed using trans-thoracic echocardiography. Results: We included 103 cases of heart disease out of a total of 8613 admissions in the pediatric department, giving an hospital prevalence of 1.2%. Mean age was 4.1 years (from 1 day to 15 years) and children under 5 years were the most affected with 73.80% of cases. Male predominance was noted (sex ratio = 1.2). Respiratory distress was the most common circumstance of discovery (93.20%). Cardiac murmur and tachycardia were the most common cardiac signs with respectively 88.35% and 83.50%. Congenital heart disease accounted for 70.87% and was dominated by ventricular septal defect (VSD) with 30.13%. Acquired heart disease (29.13% of the sample) was dominated by mitral regurgitation (MR) with 56.67%. Mortality rate was 31.9% for congenital heart disease and 11.1% for acquired heart disease. Conclusion: children’s heart disease is responsible for high mortality. Early detection improves the management of this pathology, which remains frequent.

关键词： Cardiac Disease Congenital Acquired Pediatric Bamako