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Diagnosis and Therapeutic Aspects of the Ileo-Sigmoidian Node in the General Surgery Department of Gabriel Toure Chu

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Surgical Science 2022年第1期13卷 23-27页

作者： Maïga Amadou Diakité Ibrahima Bah Amadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Sidibé Boubacar Yoro Koné Tani Doumbia Arouna Adama Traoré Amadou Saye Zakari Diallo Mamadou Konaté Moussa Saadé Oumou Hélène Kanté lassana Konaté Madiassa demb.lé Souleymane Samaké Moussa demb.lé bakary tientigui Traoré Alhassane Togo Adégné General Surgery Department University Hospital Bamako Mali General Surgery Department Sikasso Hospital Sikasso Mali Reference Center of Commune VI Bamako Mali

Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion:le="font-family:Verdana;"><

关键词： Ileosigmoid Node Digestive Surgery Bamako Mali

Epidemiological-Clinical and Therapeutic Aspects of Acute Appendicitis at the Reference Health Center of Commune III (*** CIII) of the District of Bamako

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Surgical Science 2023年第1期14卷 30-37页

作者： Karembé Boubacar Tounkara Idrissa Soumaré Modibo Dianguina Diarra Issaka Diarra Mouminy Touré Aboubacar Traoré Boureima Camara Aboubacar Sanogo Seydou Fall Ibrahim Coulibaly Abdoulaye Traoré Abdoulaye Diarra Drissa Diakité Mané Coulibaly Yacaria Kanté lassana demb.lé bakary tientigui Togo Adégné Départment of Surgery CHU Gabriel Touré Bamako Mali

Objectives: It was to determine the epidemiological-clinical and therapeutic aspects of acute appendicitis at the Reference Health Center of Commune III of the district of Bamako. Methodology: This was a prospective study from January 1 to December 31, 2020 including patients operated for acute appendicitis and confirmed at histology and cases of abscess and appendicular plastron. Results: We collected 60 cases of acute appendicitis. They accounted for 17.29% of surgical indications. The average age of our patients was 25.5 years. The male sex was the most represented at 63% with a sex ratio of 1.72. The Pain in the right iliac fossa was the most represented reason for consultation with 76.7%. It was at the type of bite 70% of the cases. On physical examination the defense of the right iliac fossa was present in 96.7%. Digestive signs were marked by nausea 28.4% (17 patients) and vomiting 25% (15 patients). The digital rectal exam was painful to the right of the Douglas fir in 76.7% of our patients. In biology a complete blood count (CBC) performed in all our patients has objectified hyper leukocytosis in 80% of cases. The reactive protein (CRP) performed in 36 patients was elevated with values between 18 and 46 mg/ml. The imaging performed was an abdominal ultrasound that found a roundel image of the appendix with increased size in 65%. Surgical treatment consisted of classical Mac Burney appendectomy in 54 patients (90%). The gesture performed was an appendectomy in all our patients. All our appendectomy parts were sent for pathological examination. This examination classified the parts as non-specific appendicitis in 60%, phlegmonous appendicitis in 22% and catarrhal appendicitis in 18% of cases. Surgical follow-up was simple in 98.4% (59 patients) and morbidity was marked by digestive fistula in one patient. We recorded one case of death (1.6%). Conclusion: Acute appendicitis remains the most common surgical emergency in commune III of the district of Bamako. It

关键词： Appendicitis Surgery Anatomical Pathology

Breast Cancer in Young Women about 87 Cases in the General Surgery Department CHU Gabriel Touré

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Surgical Science 2022年第11期13卷 506-517页

作者： Maïga Amadou Saye Zakari Sidibé Boubacar Yoro Diakité Ibrahima Bah Amadou Diallo Mahamadou Diallo Aly Boubacar Traoré Bathio Moussa Diassana Koné Tani Doumbia Arouna Adama Traoré Amadou Diallo Mamadou Traoré Djibril Konaté Moussa Saadé Oumou Hélène Kanté lassana Konaté Madiassa demb.lé Souleymane Samaké Moussa Keita Mory demb.lé bakary tientigui Traoré Alhassane Togo Adégné Department of General Surgery University Hospital Bamako Mali Department of General Surgery Sikasso Hospital Sikasso Mali Department of Orthopedic Traumatology University Hospital Bamako Mali Department of General Surgery University Hospital Bamako Mali Reference Center of Commune VI Bamako Mali General Surgery Department Mopti Hospital Mopti Mali

Our objectives were to determine the frequency of breast cancer in young women, to determine the risk factors for breast cancer in young women, to detail the diagnostic process of the disease, to determine the different therapeutic strategies. This was a retrospective and descriptive study going from January 2005 to December 2021, a period of 17 years. The study involved 87 women with an average age of 33.2 years. Patients consulted 66 times or 75.9% for breast mass. The size of the tumor was greater than or equal to 5 cm in 62 patients;it was localized in the supero external quadrant 41 times or 47.1%. Molecular classification revealed the following results: luminal A 21.4%;receptive (HER2) positive 28.6%, and triple negative 42.9%. Stage II was the most represented with 47.4%. Histology found infiltrating carcinoma of non-specific type in 76 patients. The treatment was mastectomy axillary dissection in 66 patients, quadrantectomy + axillary dissection in 6 cases (6.9%) associated with radiotherapy in 6 patients, chemotherapy was performed in 79 of our patients and hormone therapy in 10 patients. Conclusion: Breast cancer is frequent in our country. Patients generally consult us at a late stage. The possibility of determining certain receptors and carrying out certain non-surgical treatments on site would improve the prognosis.

关键词： Breast Cancer Young Woman Receptors Diagnosis Prognosis Mali

Digestive Surgical Emergencies in the General Surgery Department of the Reference Health Center in Commune I of the District of Bamako in Mali

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Surgical Science 2023年第10期14卷 646-657页

作者： Cheickna Tounkara Yacouba Fane Oumar Amadou Malle Siaka Diarra Modibo Sanogo Modibo Togola bakary Keita Hamidou Samake bakary tientigui demb.le Alhassane Traore Adégné Pierre Togo lassana Kante Zimogo Zié Sanogo Djibril Sangare Department of General Surgery and Anesthesia-Resuscitation of the Reference Health Center of Commune I Bamako Mali Directorate of the Social Health Service of the Armed Forces of Mali Bamako Mali Department of General Surgery of CHU Gabriel TOURE Bamako Mali Department of General Surgery “A” of Point G Hospital Bamako Mali

Digestive surgical emergencies concern all patients admitted urgently and for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work we have set ourselves the following objectives: Study digestive surgical emergencies in the general surgery department of the Cs ref CI of Bamako;Determine the frequency of digestive surgical emergencies;Describe the clinical and therapeutic aspects, and Analyze the results of treatment. From January 2016 to December 2016, the general surgery department of the Cs ref CI of Bamako carried out 200 digestive surgical emergencies whose files were usable;119 men and 81 women, a sex ratio of 1.5. The average age was 32.67 years;66% medical evacuation. Abdominal pain was the main reason for consultation. In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain doubtful cases, we requested paraclinical examinations (ultrasound, ASP and the rhesus group). The main etiology was acute appendicitis with 59% of cases. The frequency of digestive surgical emergencies was 35.1% of all activities of the general surgery department of the Cs ref CI of Bamako. The postoperative course was complicated in 4% of cases. Surgical site infections were the most common postoperative complications, accounting for 3% of our patients. One death was noted, i.e. 0.5% of our sample. Acute peritonitis was the cause of death in 100% of cases.

关键词： Emergency Digestive Surgery Post-Operative Complication

Traumatic Diaphragmatic Injury at Gabriel Toure University Hospital, Mali

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Surgical Science 2022年第3期13卷 110-118页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Idrissa Tounkara Mohamed Traoré Arouna Doumbia Amadou Bah Boubacar Yoro Sidibé Amadou Maïga Tani Koné Boubacar Karembé Zakari Saye Koniba Kéita Yacouba Bouaré Assitan Koné Ibrahim Diakité lassana Kanté bakary tientigui demb.lé Alhassane Traoré Adégné Togo General Surgery Department of Gabriel Touré University Hospital Bamako Mali Surgery Department of Kati University Hospital Kati Mali Reference Health Center of Commune II Bamako Mali Reference Health Center of Commune III Bamako Mali

Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases) and hemothorax (6 cases). Diagnosis of diaphragmatic lesion was preoperative in 21.7% (10 cases). The diaphragmatic breach was on the left side in 65.2% (30 cases) and the average size was 3.17 cm. laparotomy was performed in 89.1%, thoracotomy in 4.4% and thoraco-laparotomy in 6.5% of cases. The surgical procedure consisted of reduction of the herniated viscera in 15.2% (7 cases) and closure of the diaphragmatic breach with non-absorbable sutures in 82.6% (36 cases). Chest tube drainage was performed in 73.9%. The average length of hospital stay was 9.8 days. Mortality was 13.04%. Conclusion: Traumatic diaphragmatic injury is rare but its frequency is increasing in our country. It most often affects the young man victim of assault or TRA. This type of trauma is rarely isolated;you have to think about it in case of any thoraco-abdominal trauma. The treatment is surgical. The prognosis depends on the severity of the associated lesions.

关键词： Diaphragmatic Injury Trauma Surgery Gabriel Toure

Acute Intestinal Occlusions at the Cs Ref of Commune I of Bamako

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Surgical Science 2023年第12期14卷 748-757页

作者： Tounkara Cheickna Samake Hamidou Diarra Issaka Sanogo Modibo Traore Fousseyni Togola Modibo Traore Alhassane demb.le bakary tientigui Togo Pierre Adégné Kante lassana Department of General Surgery Cs Ref of Commune I Bamako Mali Directorate of the Social Health Service Armed Forces of Mali Mali Department of General Surgery Gabriel Toure University Hospital Bamako Mali

Acute intestinal obstructions are defined as a complete and persistent cessation of materials and gases in a segment of the digestive tract. They constitute a medical-surgical emergency. Our work aimed to study acute intestinal obstructions, to determine the hospital frequency, to describe the aspects (epidemiological, clinical and therapeutic), to analyze the surgical consequences and to evaluate the cost of the management of obstructions. acute intestinal infections in the general surgery department of the reference health center of commune I of Bamako in Mali. Our retrospective, longitudinal and descriptive study took place from January 1, 2015 to December 31, 2019 in the general surgery department of the reference health center in commune I of Bamako. The average age was 47.72 years with extremes of 15 and 78 years and a standard deviation of 16.07. Our sex ratio (56 men/15 women) was 3.38. The clinical signs were dominated by abdominal pain (100%), vomiting (52.9%), cessation of materials and gases (25.4%) and meteorism (35.3%). The main etiologies found intraoperatively were strangulated hernia (54.9%), bands and/or adhesions (21.1%), sigmoid volvulus (12.7%), colorectal tumor (7%), small bowel volvulus (2.8%) and acute intestinal intussusception (1.4%). Hernia repair was the most performed surgical procedure, i.e. 54.9%. The overall mortality rate was 1.4%.

关键词： Acute Intestinal Obstructions Surgery Cs Ref CI Bamako Mali

Clinical and Therapeutic Aspects of Inguinal Hernia at the Reference Health Centre of Commune II of the District of Bamako

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Surgical Science 2022年第5期13卷 265-271页

作者： Idrissa Tounkara Boubacar Karembe Souleymane Thiam Sayon Diakite Abdoulaye Diarra Amadou Traore Konimba Keita Oumar Ongoiba Moussa Sanogo Moussa l. Coulibaly bakary tientigui demb.le Adégné Togo Reference Health Center of Commune II Bamako Mali Commune III Reference Health Centre Bamako Mali University Hospital Center of Gao Gao Mali University Hospital Center of Kati Kati Mali University Hospital of Gabriel Touré Bamako Mali Regional Hospital of Tombouctou Tombouctou Mali

Objective: To study the diagnostic and therapeutic aspects of uncomplicated inguinal hernias in the general surgery unit of CSRéf CII. Method: This was a prospective, descriptive, single-centre study from 1 January 2016 to 31 December 2016 of 84 patients operated on for inguinal hernias in the general surgery unit of CSRéf CII. Results: Inguinal hernia accounted for 8% of surgical consultations and hernia repair accounted for 30.22% of surgical procedures. Hernia repair accounted for 30.22% of surgical procedures. The male sex was the most represented with a ratio of 7.40. The average age of our patients was 43.19 years. Recurrence occurred in 10% of cases. The right side was most affected in 71.43% of cases, 19.05% on the left side in;it was bilateral in 09.52%. local anaesthesia was used in 67.86% of our patients, general anaesthesia in 13.09% of cases and locoregional anaesthesia in 19.05% of cases. The hernia was external oblique in 75% of cases. Shouldice’s technique was the most used with 88%;Bassini’s technique was used in 7% and Mac Vay’s in 5% of cases. The postoperative course was simple in 96.43% of cases, with an early postoperative morbidity rate of 3.57%, one case of wall abscess and two cases of parietal haematoma. No deaths were observed during our study. Conclusion: The new methods of tension-free cure should be used more and more by our users in our facilities.

关键词： Inguinal Hernias Strangulation Management CSRéf CII

Postoperative Complications in the General Surgery Department of the Cs Ref of Commune I of the District of Bamako Mali

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Surgical Science 2024年第6期15卷 409-419页

作者： Tounkara Cheickna Samake Hamidou demb.le lamine Diarra Issaka Togola Modibo Sanogo Modibo demb.le bakary tientigui Traore Alhassane Togo Adégné Pierre Kante lassana Department of General Surgery Reference Health Center of Commune I of Bamako Bamako Mali Directorate of Social and Health Services of the Armies Bamako Mali Department of General Surgery CHU Gabriel Tour Bamako Mali

Postoperative complications represent important indicators for the quality of surgical care. The objectives of this work were to study post-operative complications in the general surgery department of the Cs ref of commune I in Mali, to determine the frequency of post-operative complications, to identify the factors of occurrence, to describe the clinical aspects, diagnostic and therapeutic in order to assess the additional cost linked to post-operative complications. This study was prospective, carried out in the general surgery department on 300 cases of surgical interventions. It covered all patients aged at least 15 years, operated on and hospitalized or not, and who presented complications during the 30 days postoperatively. Patients under the age of 15 were not included (our general surgery department is not a pediatric surgery department). We collected 300 patients among whom 199 (66.33%) were men and 101 (33.66%) women, i.e. a sex ratio = 1.9. The average age was 38 years with extremes of 15 and 87 years. The main initial diagnoses were: acute appendicitis, peritonitis, occlusions, wall hernias, hemorrhoids, uterine prolapse, uterine myomas, ovarian cysts and acute cholecystitis. Emergencies represented 43% (N = 129) of interventions with 6.98% post-operative complications (POC). Postoperative complications were dominated by surgical site infections, 75% of cases (N = 20), wall hemorrhage 5% (N = 1), testicular necrosis 5% (N = 1) and testicular calcification 5% (N = 1), wire rejection 5% (N = 1) and death 5% (N = 1). The management of postoperative complications was surgical in 95% and medical in 100%. Their occurrence extended the hospital stay by 3.65 days and increased the average cost of care by 60541.85 CFA francs. The mortality index lowered by efficient management of complications (IMAGE) calculated in relation to deaths was 95% of cases. Anemia, ASA score ≥ III, Alteimeir II and IV classes, duration of surgery and post-operative hospitalization were

关键词： Complications Post Opératoires Chirurgie Cs Ref CI Bamako Mali

Prevention of Venous Thromboembolism in General Surgery at Gabriel TouréUniversity Hospital in Mali

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Surgical Science 2021年第3期12卷 67-75页

作者： Amadou Traoré Madiassa Konaté Abdoulaye Diarra Koniba Keïta Kadia Traoré Zakari Saye Youssouf Koné Boubacar Yoro Sidibé Amadou Maïga Amadou Bah Bouréima Kelly Tani Koné Boubacar Karembé Souleymane Thiam Assitan Koné Drissa Bagayogo bakary tientigui demb.lé Alhassane Traoré Ibrahim Diakité lassana Kanté Adégné Togo Gabriel Touré University Hospital Bamako Mali

Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.

关键词： Venous Thromboembolism Prevention Surgery Mali