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Management of Adult Rectal Prolapse in the Department of Chirurgie A of the University Hospital Center of Point G about 40 Cases

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Surgical Science 2023年第6期14卷 436-440页

作者： Sacko Oumar soumare lamine soumare Ganda Traore Mamadou Salia Traore Issa Dianessy Yely Keita Sidiki Sissoko Moussa Coulibaly Bruno Soulemane Coulibaly Mahamadou Traore Adama Famoussa Keita Soumaila University Hospital Center of Point-G Bamako Mali University Hospital Center of Kati Bamako Mali Hospital of District Commune IV Bamako Mali

Aim: Reporting the department’s experience in managing adult rectal prolapse. Methods: A descriptive study was conducted in the department of chirurgie A of the chu of point G. All patients operated on for rectal prolapse in the Department of Surgery “A” were included. Technics used were altemeier procedure and anoplasty. Results: 40 cases of complete rectal prolapse were identified. The sex ratio was 1.42. Average age was 50 years. During the study period, rectal prolapse accounted for 0.13% of all pathologies encountered (n = 40) and 3.37% of anorectal pathologies. Locoregional anesthesia was performed in all patients. In the series, 36 patients (90%) were operated on using the Altemeier procedure, anal cerclage was performed in 3 patients (7.5%), and anoplasty was performed in one patient (2.5%). Postoperative mortality was 2.5% (n = 1). The postoperative follow-up was simple in 95% of cases (n = 38). Anal stenosis was found in one patient (2.5%). Conclusion: Low-way surgery remains one of the preferred options for weakened patients exposed to anesthetic risks.

关键词： Rectal Prolapse Surgery Low-Way Surgery

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

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

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

Popliteal Artery Aneurysms

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Surgical Science 2021年第4期12卷 127-134页

作者： Sidiki Keita Koniba Keita Moussa Sissoko Mamadou Coulibaly lamine soumare Oumar Sacko Oulématou Coulibaly 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 Reference Health Center of Commune VI Bamako Mali

A popliteal artery aneurysm is defined as a dilation of the popliteal artery greater than 20 mm, or greater than 50% at diameter of the native artery. Popliteal artery aneurysms are rare, but are most common in the lower extremities. These aneurysms have a high risk of ischemic complications and amputations even in unoperated patients. We describe the case of a 54-year-old man, hypertensive, with a large popliteal artery aneurysm. Doppler ultrasound and CT angiography of the lower limbs showed a 100 × 80 mm aneurysm of the popliteal artery. This aneurysm is responsible for venous compression with edema of the tissues under the skin. The patient was treated and a flattening of the aneurysm associated with bypass by the inverted right internal saphenous vein taken from the ipsilateral leg was performed. The patient was discharged on the 6th day of the operation. The patient was seen again at the outpatient clinic for one month and in the 3rd month an arterial Doppler ultrasound of the lower limbs performed had shown patency of the venous graft and disappearance of the intermittent claudication.

关键词： Artery Popliteal Aneurysm Surgery

Mortality Observed in the General Surgery Department “A” at the University Hospital Center of Point “G” in Bamako

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Surgical Science 2021年第4期12卷 119-126页

作者： Sidiki Keita Koniba Keita Moussa Sissoko Mahamadou Coulibaly lamine soumare Oumar Sacko Oulématou Coulibaly Sekou Koumaré Adama Keita Adama K. Koita Soumaîla Keita Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G Bamako Mali General Surgery Department Hospital BSS Kati Mali Reference Health Center of Commune VI Bamako Mali

In Mali, few studies have concerned overall mortality in general surgery, but several specific studies have concerned the different affections. Reflection on the causes of death is an inherent part of the activity of any motivated surgical team. Objective: To analyze the rate and the main causes of mortality in the General “A” surgical department of the Point “G” CHU. Patients Method: Our study was retrospective, descriptive and covered a period of 5 years from 01/01/2014 to 12/31/2018. We collected 152 deaths for 2011 hospitalized patients. The data were collected from the files of these deaths on pre-established investigation forms. The deceased patients were classified as operative and non-operative death, death from non-cancerous and cancerous diseases, deaths occurring in emergencies and deaths in regulated surgery. Results: We recorded 152 cases of death for 2011 hospitalized patients, either an overall mortality rate of 7.55%. The average age of deaths was 44.20 years +- 17.51 years with extremes ranging from 7 years to 85 years. The sex ratio was 1.62 in favor of men. The causes of death were represented by cancerous pathologies (69 deaths or 34.67%), non-cancerous pathologies (83 deaths or 4.58%). Conclusion: The mortality rate in general surgery remains high and is mainly linked to cancerous pathologies and the delay in taking care of patients.

关键词： Mortality General Surgery Cancer Non-Operated Operated

Peritonitis Management through Appendicular Perforation in the Department of Surgery Bougouni Hospital (Mali)

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Surgical Science 2020年第12期11卷 446-452页

作者： Sidiki Keita Koniba Keita Mahamadou Coulibaly Moussa Sissoko lamine soumare Oumar Sacko Sekou Koumaré Adama K. Koita Soumaîla Keita M. Doumbia Dramane Zimogo Zié Sanogo General Surgery “A” Department Hospital Point-G. Bamako Mali General Surgery Department Hospital BSS Kati Mali

Introduction: Appendicular peritonitis is a complication of acute appendicitis characterized by the spread of the infectious process in the peritoneal cavity thus achieving wide spread or localized purulent peritonitis;it’s a medico-surgical emergency. Our objectives are to determine the frequency, describe the clinical, therapeutic and prognostic aspects of peritonitis by appendicular perforations. Patients-Method: This was a 24-month retro, prospective, descriptive study from January 1, 2018 to December 31, 2019;conducted in the Bougouni Reference Health Center Surgery Unit. All patients of appendicular peritonitis at the Bougouni Reference Health Centre were included. Results: During the study period, 68 cases of generalized acute peritonitis including 30 appendicular peritonitis cases were collected. Appendicular peritonitis accounted for 44.1% of surgical procedures. Males accounted for 71.0% with a sex ratio of 1.2 at risk of men, the average age was 26.07 years. Abdominal pain and vomiting were the reasons for consultation in 86.7% and 76.7% of cases. Physical examination was used in most cases to make the diagnosis. X-ray of the abdomen without preparation, and abdominal ultrasound were performed systematically. Surgical treatment consisted of an appendectomy with peritoneal toilet followed by drainage. The average length of hospitalization was 8.8 days with extremes of 1 - 44 days. Hospital mortality was 3.3%;morbidity and high mortality were related to delayed consultation. Conclusion: Appendicular generalized acute peritonitis is a medical-surgical emergency with a high mortality rate associated with delayed management.

关键词： Appendicular Peritonitis Surgical Emergencies Appendectomy

Consent and Quality of Information for Patients in Laparoscopic Surgery at the Academic Hospital Point“G”(Mali)

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Surgical Science 2018年第12期9卷 502-508页

作者： Soumaila Keita Madiassa Konate Mamadi Coulibaly Abdoulaye Kante Traore Amadou Diarra Mamadou Salia Marius Sanou Aboubacar Sidiki Sangare lamine soumare Sekou Koumare Oumar Sacko Brahima Dicko D. Kanikomo Zimogo Zie Sanogo Service de Chirurgie A CHU du point GBamakoMali

Objectives: To evaluate the quality of the information provided to patients for their consent to be operated laparoscopically in the “A” surgery service of Point “G” University Hospital in Bamako (Mali). Methodology: The study was transversal, descriptive and prospective from November 1, 2016 to December 31, 2017 (14 months). It was performed at the general and laparoscopic surgery department of the Point “G” University Hospital in Bamako. Laparoscopically operated patients in scheduled or emergency programm whom consented the study and answered the questions before and after the surgical procedure were included. Results: One hundred patients were retained. The sex ratio was 4.2 for women. The surgery was scheduled in 93% (programmed surgery) of cases versus 7% (urgent surgery). Gynecological and obstetric surgery was performed in 54%, digestive surgery in 43% and laparoscopic exploration in 3%. The information was provided by surgeons, anesthetists, fellowship and students in respec-tively 63%, 6%, 11% and 9%. The reflection period before consenting to the act was greater or equal to 3 days in 90%. The media used were found to be suitable in 62%. The information was considered satisfactory preoperatively in 54% and postoperatively in 88%. Patients wanted additional information on post-surgery outcomes in 21%. Conclusion: The establishment of an information system and a free and informed consent form is a prerequisite for the quality of care in laparoscopic surgery.

关键词： Laparoscopy Information Consent

Infantile Spinal Muscular Atrophy at the Albert Royer National Children’s Hospital Center in Dakar

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Open Journal of Pediatrics 2024年第3期14卷 514-521页

作者： Guillaye Diagne Khadim Bop Sofiatou Dieye Arame Faye Fatou Ly Amadou lamine Fall Pediatrics Ward of Pikine Hospital Pikine Senegal Pé diatrics Ward of Albert Royer National Hospital Dakar Senegal

Introduction: Infantile spinal muscular atrophy (ISA) is an autosomal recessive disease caused by primary degeneration of cells in the anterior horn of the spinal cord, leading to muscle weakness and hypotonia. Its incidence is estimated at 1 in 6000 births worldwide. In Africa, particularly in Senegal, there are few studies interested on this pathology. We therefore deemed this study necessary, which set itself the objective of describing the diagnostic, therapeutic and progressive aspects of infantile spinal muscular atrophy at the Albert Royer National Children’s Hospital Center in Dakar (CHNEAR). Methodology: We conducted a retrospective descriptive study over a period of two (2) years from December 2020 to December 2022. Included were all hospitalized patients in whom the diagnosis of spinal muscular atrophy was made with or without genetic confirmation. The data were collected on a pre-established form then entered and analyzed with the following software: Excel 2013 and R version 4.1.3. Results: During our study period, 2100 children were hospitalized, the annual incidence was 0.76%. The average age of our patients was 9 ± 9 months with a range of 3 months to 32 months and the median was 6.5 months. The sex ratio was 7. The notion of family consanguinity was found in 62.5% of cases and the notion of ISA in the family in 25% of cases. Hypotonia and respiratory distress were found at the forefront in equal proportions (50% of cases). Electromyogram (EMG) was performed in 3 patients (37.5%). Symptomatic medical treatment was administered in 100% of patients, 04 patients had benefited from respiratory physiotherapy, i.e. 50% of cases, and genetic counseling was carried out in one patient (12.5%). The evolution was immediately favorable in 2 patients or 25% of cases, unfavorable in 75% of cases with a death rate of 50% and the average age of death was 5.5 months ± 1 with extremes ranging from 3 to 7 months. Conclusion: The number of Infantile spinal muscular atrop

关键词： Spinal Muscular Atrophy Child Hypotonia Dakar