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Surgical Science 2023年第9期14卷 575-582页

作者： Cheickna Tounkara Amadou Maiga Boubacar Yoro Sidibe tani kone Hamidou Samake Kaloga Daye Bagayoko Oumar Amadou Malle Jean Baptiste Honoré Berthe Mamadou Lamine Diakite Department of General Surgery of the “Mother Child” Hospital Luxembourg Bamako Mali General Surgery Department of Gabriel TOURE Hospital Bamako Mali Urology Department of Point-G Hospital CHU Bamako Mali

Ureteral duplication is a congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. Our objective was to show the importance of the morbidity linked to the late diagnosis of this anomaly, the incidence of the infection and the complications that this pathology poses as a problem. It was a clinical case of fortuitous discovery taken care of by a general surgeon in the general surgery department of the hospital “Mother Child” Le Luxembourg Bamako Mali. We report a case of complete ureteral duplication complicated by ureterohydronephrosis on a lithiasis wedged in the uretero-vesical junction of one of the left ureters in its lower portion which required a uretero-lithotomy with bladder reimplantation of the left ureters and secondly to a uretero-lithotomy with bladder reimplantation after two months. The postoperative course was simple.

关键词： Ureteral duplication Congenital malformation Duplicity Adult Bamako Mali

Case of Incomplete Ureteral Duplication Complicated with Lithiasis and Right Uretero-Hydronephrosis

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Surgical Science 2023年第7期14卷 502-506页

作者： Cheickna Tounkara Amadou Maiga Boubacar Yoro Sidibe tani kone Samake Hamidou Kaloga Daye Bagayoko Oumar Amadou Malle Jean Batiste Honoré Berthe Mamadou Lamine Diakite Department of General Surgery Luxembourg Hospital Bamako Mali Department of General Surgery CHU Gabriel Touré Bamako Mali Department of Urology Surgery CHU Point-G Bamako Mali

Ureteral duplication is congenital malformative uropathy that occurs most often in children. Complete ureteral duplication is defined by a kidney that has two ureters with two orifices that communicate to the bladder through two ureteral meati. It is an anatomical variant that remains rare. Its early discovery is due to a lack of diagnostic means, hence the occurrence of long-term complications. To this end, we observe an increased importance of the morbidity linked to the late diagnosis of this duplicity. We report a case of incomplete ureteral duplication complicated by ureterohydronephrosis on lithiasis wedged in the uretero-vesical junction of one of the ureters in its lower portion which required uretero-lithotomy with bladder reimplantation of the ureters. Our aim was to show the importance of the morbidity associated with late diagnosis of this anomaly and the incidence of infection and complications that this pathology poses as a problem. This was a clinical case of fortuitous discovery managed by a general surgeon in the general surgery department of the hospital “Mère Enfant” Le Luxembourg Bamako Mali. The suites were simple.

关键词： Ureteral Duplication Congenital Malformation Adult

Inguinal Hernia in Adults: Diagnostic and Therapeutic Aspects at Cs Ref CI Bamako Mali

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Surgical Science 2023年第7期14卷 507-516页

作者： Cheickna Tounkara Amadou Maiga Bessy Samake Boubacar Yoro Sidibe tani kone Samake Hamidou Kaloga Daye Bagayoko Oumar Amadou Malle Alhassane Traore Bakary Tientigui Dembele Pierre Adégné Togo Zanafon Ouattara Department of General Surgery of the Reference Health Center of Commune I Bamako Mali Department of General Surgery CHU Gabriel TOURE Bamako Mali Department of Urology Surgery Point G University Hospital Bamako Mali

The inguinal hernia is a very frequent surgical pathology in the world and it represents 95% of the hernias of the groin. This work aimed to determine the frequency of inguinal hernias, describe the clinical and therapeutic aspects of inguinal hernias, describe the morbidity and mortality related to inguinal hernias and evaluate the cost of treatment. Our study was conducted from January 2010 to December 2010 in the general surgery department of the Reference Health Center of Commune I in the district of Bamako. We collected 130 cases of inguinal hernias with a sex ratio of 15.25 in favor of the male sex. The mean age was 48.02 years (standard deviation: 17.53 years). Strangulated inguinal hernias accounted for 4.9% of abdominal surgical emergencies and 14.6% of all operated inguinal hernias. More than half of the patients (82%) were operated under local anesthesia. Clinical signs were marked by painless or irreducibly painful inguinal swelling. The diagnosis was clinical in all patients. Some patients benefited from a minimum blood assessment (rhesus grouping, glycaemia, hemoglobin level and hematocrit). The Shouldice technique was performed in 68% of patients. One case of organ resection was performed, i.e. 0.8% of cases. Morbidity was 4.6% due to wall abscess;0.8% scrotal hematoma type. We have not recorded any recurrence or death.

关键词： Inguinal Hernias Surgery Cs Ref CI Bamako (Mali)

Abdominoperineal Resection in Rectal Cancer in General Surgery Department at Gabriel Toure University Hospital

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Surgical Science 2019年第1期10卷 16-23页

作者： Amadou Traore Abdoulaye Diarra Madiassa Konate Souleymane Thiam Soumaila Keita tani kone Boubacar Karembe Assitan kone Boubacar Sidibe Amadou Bah Amadou Maiga Ibrahim Diakite Bakary Tientigui Dembele Alhassane Traore Adegne Togo Lassana Kante Moussa Samake Moustapha Issa Mangane Thierno Madane Diop Mamadou Salia Diarra Adama Diakite Gangaly Diallo Gabriel Toure University Hospital BamakoMali

The objectives: Were to determine the hospital frequency of abdominoperineal resection (APR);to determine mortality and morbidity rates and to assess oncologic outcomes. Method and patients: We performed a retrospective study between 2008 and 2013 in general surgery department at Gabriel Toure University Hospital (UH) which included all patients admitted for rectal cancer confirmed by pathological examination, and having undergone an APR. Results: We have collected 17 cases which accounted for 65.38% of curative resections of rectal cancer. The sex-ratio was 0.89 and the averageage was 49.53 years. The average tumor distance from the anal verge was 4.59 ± 1.7 cm. All patients had adenocarcinoma of the rectum. The histopathologic grade was well in 7 cases, moderate and poor in 5 cases each. According to the pathologic TNM classification, 13 patients were classified T4, 14 patients N+. APR was associated with hysterectomy and partial colpectomy in 4 cases. The average duration of interventions was 202.06 ± 25.68 minutes. The average duration of hospitalization was 18.24 ± 04.89 days. The postoperative mortality and morbidity rates were 5.88% and 29.42%, respectively. Local recurrence was observed in 6 patients and liver metastasis in 2 patients. The overall survival rate was 37.5% at 2 years and 18.75% at 5 years. Conclusion: APR still occupies an important place in our practice. Our results could be improved by the recent introduction of neoadjuvant radio chemotherapy in Mali.

关键词： Abdominoperineal Cancer Mali Rectum Resection Surgery

Urgent Surgical Management of Acute Lower Gastrointestinal Bleeding with Intraoperative Colonoscopy: A Case Report

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Surgical Science 2018年第9期9卷 300-305页

作者： Traore Amadou Konate Madiassa Diarra Abdoulaye Keita Soumaila kone tani Karembe Boubacar Amadou Issa Sidibe Boubacar Bah Amadou Maiga Amadou Diakite Ibrahim Dembele Bakary Tientigui Traore Alhassane Togo Adegne Kante Lassana Samake Moussa Mangane MoustaphaIssa Diop Thierno Madane Diakite Adama Diallo Gangaly Gabriel Toure University Hospital Bamako Mali

Lower gastrointestinal bleeding (LGIB) is defined as bleeding from a source distal to the Ligament of Treitz. The primary step is to identify severe hemorrhages that may be life-threatening for patients (10% of cases of LGIB). The management depends on the severity of the bleeding, the diagnostic and therapeutic means of the patient’s reception center. Patient with acute LGIB, in case of negativity of endoscopic and radiological examinations, can be a surgical indication with possibility of intraoperative colonoscopy. We report a case of urgent surgical management with intraoperative colonoscopy in a patient with severe acute LGIB.

关键词： Lower Gastrointestinal Bleeding Surgery Gabriel Toure