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

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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Perforations of Gastro-Duodenal Ulcers in the Surgery Department “A” at the University Hospital Point G Bamako

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Surgical Science 2019年第8期10卷 265-270页

作者： O. Sacko S. Diallo L. Soumaré M. Camara S. Koumaré M. Sissoko S. Keita Carol D. Dakouo M. Coulibaly M. Traoré G. Soumaré A. F. Traoré H. Dicko Y. Dianessi B. Traoré A. Koita sanogo zimogo Department of Surgery “A” University Hospital of Point G Bamako Mali Department of Surgery “B” University Hospital of Point G Bamako Mali Department of Gynecology-Obstetrics University Hospital of Point G Bamako Mali Department of Internal Medicine University Hospital of Point G Bamako Mali Department of Intensive Care University Hospital of Point G Bamako Mali

The purpose of this study was to investigate the clinical and therapeutic aspects of peritonitis by perforation of gastric and duodenal ulcer. This was a retrospective and descriptive study over 8 years (2010-2018) which allowed to collect 54 cases of peptic ulcer. Included in the study were all patients with confirmed gastroduodenal perforation on histology or laparotomy. We collected 54 cases of peptic ulcer perforated s. The age group of 30 - 49 years was the majority. The male sex was dominant with 90.7% of cases;the clinical picture was dominated by abdominal contracture associated with pain in 74.07% of cases. X-ray of the abdomen without preparation (AWP) revealed in 87.03% of cases of pneumoperitoneum. The perforation was in 68.52% of cases on the gastric antrum and in 31.48% on the duodenum. The surgical procedure used was the bank of excision, and a suture reinforcement epiploic in 68.52% of cases, a simple suture made in 31.48% of cases, the disease was marked by a fistula (1.90%) and mortality was 5.55% of cases. The gastroduodenal ulcer perforation is potentially serious and responsible peritonitis whose surgical treatment involves the peritoneal toilet and sutures the puncture.

关键词： Perforated Gastric or Duodenal Ulcer Peritonitis Surgery

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Splenectomy in the Surgery Department “A” at the University Hospital Point G Bamako

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Surgical Science 2019年第10期10卷 347-354页

作者： O. Sacko M. Sissoko S. Koumaré L. Soumaré M. Camara S. Keita S. Diallo D. Dakouo M. Coulibaly A. Diakité M. Traoré G. Soumaré A. F. Traoré B. Touré M. Diallo M. Konaté A. Koné Y. Dianessy B. Traoré A. Koita sanogo zimogo Department of Surgery “A” University Hospital of Point G Bamako Mali Department of Surgery “B” University Hospital of Point G Bamako Mali Department of Gynecology-Obstetrics University Hospital of Point G Bamako Mali Department of Internal Medicine University Hospital of Point G Bamako Mali Department of Hematologie University Hospital of Point G Bamako Mali Reference Health Center of Commune 6 Bamako Mali.

We conducted a retrospective study that included patients with erythrocyte and hemolytic pathology justifying a splenectomy and patients presenting splenic trauma for which hemostasis splenectomy is required. We performed 27 total splenectomy in which 26 are by laparotomy (92.86%) and 1 by laparoscopy (3.57%). A partial splenectomy was performed by laparoscopy. The morbidity was marked by 2 cases of infectious syndrome and 1 case severe anemia. The mortality was 7.14% (n = 2). Splenectomy is part of the therapeutic arsenal for benign or malignant hematological disorders that constitute the main indication for elective splenectomy. Splenectomy was one of the most common operations in abdominal surgery. During the past decade, an increased rate of late complications, specially septic and thromboembolic complications are well documented. The risk is related to the indication of splenectomy, and is less than 1% in adults without immunodeficiency. However, these overwhelming postsplenectomy infections are associated with a high mortality rate. The best treatment of these infections is preventive measures which are based on vaccination and education of asplenic patients.

关键词： Splenectomy Hematology Septic Complication Vaccination

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Laparoscopic Cholecystectomy at the Centre Hospitalier Universitaire (CHU) Mère-Enfant le “Luxembourg” in Mali for 2 Years from 2020 to 2021

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Surgical Science 2022年第12期13卷 585-591页

作者： Amara Coulibaly Abdoul Karim Simaga Moussa Sissoko Sekou Koumaré Mamedy Doumbia Sidiki Konaré zimogo Zie sanogo Surgical Department “A” of the University Hospital Center (CHU) of Point-G Bamako Mali Surgical Department of the Centre Hospitalier Universitaire Mère-Enfant (CHU-ME) le “Luxembourg” Bamako Mali

Introduction: Laparoscopic cholecystectomy is a surgical technique that involves the removal of the gallbladder by laparoscopy. Its practice is timid in sub-Saharan Africa, despite the existence of risk factors such as sickle cell disease. We report our 2-year experience of laparoscopic cholecystectomy in the general surgery department of the CHU-ME Luxembourg. Materials and Method: This was a descriptive cross-sectional study from September 2019 to September 2021. The study included 64 patients with vesicular lithiasis who underwent laparoscopic cholecystectomy. Data were analyzed on SPSS software (version 25.0). Confidentiality and anonymity of the subjects were respected. Results: The frequency of cholecystectomy was 30.9%. The average age was 38.37 ± 16.94 years. The female sex was 70.3%. Obesity and sickle cell disease were found in 85.9% and 14.1% of patients. On physical examination, hepatic colic was found in 54.7% and the Murphy sign was positive in 64.1% of patients. Ultrasound diagnosis of vesicular lithiasis was made in all patients. All patients underwent laparoscopic cholecystectomy, which was retrograde in 64.1% of cases. The average procedure time was 66 minutes. No case of complication was recorded postoperatively. Conclusion: Laparoscopic cholecystectomy is a technique to be developed and supported.

关键词： Cholecystectomy Laparoscopic Lithiasis Mali

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Appendicular Mucocele: About a Case Observed in Bamako

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Surgical Science 2022年第12期13卷 577-584页

作者： Amara Coulibaly Abdoul Karim Simaga Moussa Sissoko Sekou Koumare Sidiki Konare Mamedy Doumbia zimogo Zié sanogo Department of Surgery “A” of the University Hospital Center (CHU) of Point-G Bamako Mali Surgery Department of the Mother-Child University Hospital Center (CHU-ME) “Luxembourg” Bamako Mali

It is a globally rare condition that can present in a variety of clinical syndromes or can occur as an incidental surgical finding. It poses the double problem of its possible malignancy and the risk of gelatinous disease of the peritoneum in the event of perforation. We report a case treated in the “A” Surgery Department of the Point-G University Hospital Center (CHU) in Mali in 2022. It was a 62-year-old woman, a housewife who presented to the department. “A” surgery at the Point G University Hospital Center for pain in the iliac fossa. As a medical history, she was hypertensive on atenolol and a known diabetic on diet and metformin-based treatment, as well as symptomatic sickle cell disease (AS) and an undocumented history of peptic ulcer disease. The biological assessments revealed hyperleukocyte with granulocyte predominance. C-reactive protein was positive at 32 mg/l. Ultrasound revealed a 27 mm cystic dilation of the appendicitis in favor of appendicular mucocele. We proceeded with the appendix. The surgical specimen containing gelatinous fluid was removed and histological examination was in favor of a mucinous adenocarcinoma of the appendix.

关键词： Appendicular Mucocele Appendicular Tumor Bamako

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Acute Peritonitis at the CSRef of the Commune I in the District of Bamako: Signs, Diagnosis and Treatment

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Surgical Science 2023年第10期14卷 626-636页

作者： Cheickna Tounkara Oumar Amadou Malle Modibo Togola Hamidou Samake Lamine Soumare Sékou Koumare zimogo Zié sanogo Djibril Sangare Department of General Surgery 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 “A” of Point G Hospital Bamako Mali

Acute generalized peritonitis is an acute inflammation of the peritoneum. It is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The absence of a study on peritonitis in a reference health center motivated us for this work. The aim of this study was to study the inadequacies that could be seen in the management of peritonitis in the CSRef(s). We carried out a retrospective study of 40 patients received at the CSRéf of commune I for acute generalized peritonitis from 2011 to 2012. The average age was 30.1 years with a standard deviation of 3.4;extremes ranging from 14 years to 60 years and a Sex ratio = 1.22 (22 men out of 18 women). Abdominal pain was the main reason for consultation (present in all our patients). In most cases, clinical examination alone made it possible to make the diagnosis. Surgical treatment depended on the etiology (appendectomy associated with washing-drainage was the most commonly performed surgical procedure). All our patients received general anesthesia. The average length of hospitalization was 7 days with extremes ranging from 1 to 15 days. We noted a Morbidity rate of 22.5%, dominated by wall abscesses and a mortality of 2.5%. The delay in consultation and referrals constitutes a factor in mortality and high morbidity.

关键词： Peritonitis Surgery Csref CI Bamako Mali

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Review of Laparoscopic Activities at the University Hospital Center (CHU) “Mère-Enfant Luxembourg” in 100 Cases

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Surgical Science 2023年第2期14卷 143-150页

作者： Amara Coulibaly Moussa Sissoko Sidiki Konaré Abdoul Karim Simaga Sekou Koumaré Drissa K. Bagayoko Cheichna Tounkara zimogo Zié sanogo Surgical Department “A” of The University Hospital Center (CHU) of Point-G Bamako Mali Surgical Department of The Centre Hospitalier Universitaire Mère-Enfant (CHU-ME) le “Luxembourg” Bamoko Mali

Introduction: Laparoscopic surgery is a surgical technique that allows to intervene under the control of an endoscope, introduced into the abdominal cavity previously distended by an artificial pneumoperitoneum. We propose in this study to bring the assessment of the laparoscopic activities in the department of general surgery at the CHU MERE-ENFANT “Luxembourg”. Methodology: This was a descriptive cross-sectional study from September 2019 to September 2020 including 100 cases of laparoscopic procedures at the University Hospital Mother and Child “Luxembourg”. All patients regardless of pathology, who underwent laparoscopic surgery with or without conversion to conventional surgery were included in the study. The data were collected from routine media such as the consultation register and the operative report register. Data analysis was performed using SPSS 21 software. Informed consent was obtained from the patients before their inclusion in the study, and each patient was assigned an anonymity number. Results: In our study, the female sex represented of the patients, i.e. 76% with a sex ratio of 3.2. Housewives were 53% of the cases. The majority of patients were in the age range of 16 - 30 in 44% of cases and 75% were married. Overweight/obesity, hypertension and peptic ulcer were the main medical histories with 22%, 12% and 10% respectively. All patients presented with abdominal pain. Cholecystectomy was the main activity during the study with a frequency of 43%, followed by tube surgery and appendectomy. The average duration was 53 minutes for digestive pathologies 48 minutes with extremes of 22 and 66 minutes for gynecological pathologies. One case of injury to the cystic artery was recorded. The conversion rate was 6% of cases. We recorded 5 cases of suppuration as a postoperative complication. The length of stay was 2 - 3 days in 96% of patients. Conclusion: In view of this study, the feasibility of laparoscopic surgery at the CHU Mère Enfant “Luxembourg” is

关键词： Laparoscopic Surgery Assessment Mali

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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 Dembele 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

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Compressif Giant Segmental Congenital Emphysema: Diagnosis and Traitment

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Surgical Science 2016年第4期7卷 195-198页

作者： Moussa Abdoulaye Ouattara Seydou Togo Abdoul Aziz Diakité Ibrahima Sankaré Bourama Kané Sekou Koumaré Mody Abdoulaye Camara zimogo Ziè sanogo Sadio Yena Department of Thoracic Surgery Hospital of Mali Bamako Mali Department of Pediatric Gabriel Touré Teaching Hospital Bamako Mali Department of Surgery Point G Teaching Hospital Bamako Mali Department of Imagery Hospital of Mali Bamako Mali

The giant congenital lobar emphysema is a rare malformation infant pathology. The authors report a similar case which is distinguished by its segmental location even rare with its compressive character in which segmen... 详细信息

关键词： Emphysema Congenital Segmentectomy

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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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