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

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

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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

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Prolapsed Juvenile Polyp of the Anus in 2 Cases

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Open Journal of Pediatrics 2023年第6期13卷 785-790页

作者： Mohamed Lamine Sadou sacko Balla Keita Thierno Saidou Barry Mory Sangare Mamadou Madiou Barry Moussa Conde Seydou Keita Salif Mariértou Sylla Daniel Agbo-Panzo Department of Pediatric Surgery CHU de Donka Conakry Guinea Gamal Abdel Nasser University Conakry Guinea General Surgery Department Ignace Deen University Hospital Conakry Guinea Gastroenterology Department Conakry Military Hospital Conakry Guinea

Introduction :Rectal polyps are well-circumscribed, sessile or pedunculated formations that develop on the digestive mucosa. Juvenile polyps are seen in 4% - 12% of cases during pediatric colonoscopies. In children, rectal bleeding is a frequent warning sign, often a recurrent bleed with no impact on general condition. Diagnosis is based on clinical, imaging and digestive investigations, but anatomopathological examination remains the only means of confirmation. There are a number of treatment options, ranging from abstention to surgical excision. We report two (2) cases of isolated hemorrhagic juvenile polyp prolapsed to the anus in order to analyze the diagnostic and therapeutic features of this pathology. Patients and observations: A 7-year-old female patient presented to the pediatric emergency department of the Donka National Hospital with a hemorrhagic anal mass. On clinical examination, the patient was found to be in satisfactory general condition, with a hemorrhagic pedicle mass prolapsed to the anus. The mass was removed under general anesthesia. Postoperative management was straightforward. Conclusion: Juvenile polyps are the most common proctological condition in this age group. Clinical examination must be meticulous, as certain signs may point to a particular pathology. Colonoscopy is the diagnostic test of choice, and can also be used as a therapeutic tool.

关键词： Polyp Juvenile Prolapse Child

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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

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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

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Cardio-Renal Syndrome: Epidemiological Aspect in the Medicine Department of Tombouctou Hospital

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World Journal of Cardiovascular Diseases 2022年第2期12卷 123-132页

作者： Bassirima Traore Samba Sidibé Souleymane Mariko Karamoko Kantako Massama Konaté Kalifa Diallo Nouhoum Diallo Mariam Sako Abdoul Karim sacko Youssouf Kassambara Ichaka Menta Souleymane Coulibaly Department of Medicine Tombouctou Hospital Tombouctou Mali Cardiology Department of the Point G University Hospital Bamako Mali Cardiology Department Mali Hospital Bamako Mali Cardiology Department CHU Gabriel TOURE Bamako Mali

Introduction: Cardio-renal syndrome is a pathophysiological disorder of the heart and kidneys in which chronic or acute dysfunction of one can lead to chronic or acute dysfunction of the other. The objective of this study was to determine the prevalence of cardio-renal syndrome in the Medical Department of the Tombouctou Hospital in Mali. Methods: It is about a descriptive transversal study carried out over 18 months, from January 01st, 2020 to June 30th, 2021 and relating to the analysis of 75 files of patients hospitalized for heart failure and with impaired renal function. Results: The frequency of cardio-renal syndrome was 6.4% with a predominance of men (sex ratio: 2). Hypertension was the most widely described risk factor (50.6%). The history was dominated by chronic heart failure (14.6%) and diabetes (6.6%). The average age was 58 with extremes of 18 and 90. The main aetiologies were dilated cardiomyopathy (46.6%) and ischemic heart disease (20%). Symptoms were dominated by dyspnea (90.6%) and edema of the lower limbs and face (74.6%) accompanied by cough (74.6%). Anemia was noted in 15 patients (20%). The mean clearance (MDRD) was at 32 ml/min. Doppler echocardiography found left ventricular dilation (66.6%), lower left ventricular systolic fraction (64%) and kinetic abnormalities (20%). The kidney ultrasound performed in 9 patients returned to normal in 8 cases and in 1 patient the kidneys were small. Eight deaths (10.6%) were noted. Conclusion: Cardio-renal syndrome is a common feature in which mixed failure is observed in the unfavorable course of heart disease and nephropathy. Its prevalence is unfortunately under evaluated in cardiological settings in Africa and particularly in Mali, hence the interest of a more advanced study.

关键词： Cardio-Renal Syndrome Epidemiology Tombouctou Hospital

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Fertility after Neosalpingostomy through Laparoscopic Way in Point “G” Teaching Hospital

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Surgical Science 2019年第2期10卷 49-58页

作者： Kéita Soumaila Traoré Youssouf Soumaré Lamine Koumaré Sekou sacko Oumar Camara Aboubacar Camara Moussa Sissoko Moussa Abdoulaye Sissoko Koita Adama Sanogo Z. Zimogo Surgery Department “A” Point G Teaching Hospital Bamako Mali Faculty of Medicine and Odonto Stomatology of Bamako University of Science Technique and Technologies of Bamako (USTTB) Bamako Mali

The endoscopic surgery is actually the golden standard for the management of infertility. Its results look better than classical surgery. The aim of the study was to assess the fertility rate among infertile women who have undergone a laparoscopic distal tubal plasty and to estimate factors influencing this fertility. From January 2007 to December 2016 a descriptive and analytical cross sectional retrospective study was conducted in the departments of general and laparoscopic surgery of the Point “G” Teaching Hospital in Bamako, Mali. Clinical records of 120 laparoscopic patients with distal tubal occlusion who have undergone a neosalpingostomy were collected. Average period of infertility was 6.7 years (from 1 to 25 years), and the average duration before laparoscopic surgery was 5 years. Main abnormalities were: 50 cases of bilateral tubal distal occlusion (41.7%), 14 patients with unilateral tubal distal occlusion (11.7%), 44 cases of bilateral hydrosalpinx (36.6%) and 12 cases with unilateral occlusion (10.0%). Seventeen patients had adhesions (14.1%) including 4.0% of tubo-peritoneal adhesions, 35.5% of tubo-ovary adhesions and Fitz Hugh and Curtis syndrom adhesions in 17.7% of cases. More than half of the patients (58.0%) had a grade II tubal score. Neosalpingostomy had led to bilateral tubal repermeabilization among 60.0% of the patients. Thirty two point five percent (39/120) pregnancies have been observed after the management. Conception probability was null after the 4th post operative year. The majority of pregnancies have been observed in the 11th month after laparoscopic management. During the follow-up, thirty one patients had intrauterine pregnancy (79.5%), four ectopic pregnancies and three miscarriages. The occurrence of pregnancy was influenced by the desire of the woman, the absence of co-morbidity, the tubal score, the result and the quality of the laparoscopic gesture and the duration of the fertility. Conclusion: In our working setting, neosalp

关键词： Fertility Laparoscopy Neosalpingostomy Pregnancy

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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 fatoum.ta 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

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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

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China's successful experience in poverty reduction, agricultural development welcomed in Africa

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一带一路报道(中英文) 2022年第2期 19-19页

作者： Josefa sacko Rural Economy and Agriculture

China can replicate its successful experience in poverty reduction and agricultural development in its engagements across *** is very important from their experience, because I had the opportunity to go to China and I saw the way they transform the rural area into urban area. I hope they will do the same for ours.

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