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Perception and Management of Hemorroid Disease at the csref of the Commune Bamako Mali

Surgical Science 2024年第2期15卷 89-97页

作者： Tounkara Cheickna Diarra Mohamed Hassimy Diarra Issaka Sanogo Keita Bakary Dembele Bakary Tientigui Traore Alhassane Togo Pierre Adégné Lassana Kante department of general surgery The Cs Ref of Commune I of Bamako Bamako Mali department of general surgery The Gabriel TOURE University Hospital in Bamako Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at cs ref ci. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

关键词： Hemorrhoidal Disease Caregivers Traditional Therapists Patients surgery cs ref ci

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Study of Hemorrhoid Disease in the department of general surgery of the cs ref of the Commune I Bamako

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Surgical Science 2024年第2期15卷 36-47页

作者： Tounkara Cheickna Diarra Issaka Sanogo Modibo Togola Modibo Camara Ladji Soma Dembele Bakary Tientigui Traore Alhassane Togo Adégné Pierre Kante Lassana Ouattara Zanafon Diallo Gangaly department of general surgery The Reference Health Center in Commune I Bamako Mali department of general surgery The Gabriel Toure University Hospital Bamako Mali department of Urology The Gabriel Toure University Hospital Bamako Mali

This work was a retrospective prospective study carried out in the general surgery department of the cs ref of commune I from January 2009 to December 2012. Our study aimed to determine the hospital frequency of hemorrhoidal disease, to identify the contributing factors, describe the clinical and therapeutic aspects and analyze the surgical consequences. We collected 73 patients with an average age of 37.8 years (range: 19 years and 77 years) with a sex ratio of 2.5 in favor of men. We operated on 49 patients or 67.1% of cases. 71.2% of our patients were married and lived in Bamako. Schoolchildren and middle managers made up 39.8% of cases. 82.2% of patients were seen in ordinary consultation and 69.9% complained of progressive anal pain in 66.7% of cases. This pain was triggered by defecation in 88.2% of our patients. The contributing factors were dominated by constipation (53.4%), working in a seated position (41.1%) and a sedentary lifestyle (16.4%) of cases. Stage IV external hemorrhoids and hemorrhoidal thrombosis represented 53.8% of surgical indications. The most used surgical technique was that of Milligan-Morgan, i.e. 51.9% of cases and 45.2% of patients treated medically received a combination of transit regulator, venotonics and analgesics. The surgical aftermath was marked by hemorrhage (3 cases), delayed healing (5 cases), urinary retention (1 case) and scarring anal stenosis (1 case). The morbidity rate was 5.48% of cases and a zero mortality rate. The average length of hospitalization was 2 days with extremes of 1 and 5 days.

关键词： Hemorrhoid surgery cs ref C I Bamako Mali

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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 Dembele Lamine Diarra Issaka Togola Modibo Sanogo Modibo Dembele 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

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Effects of neoadjuvant chemotherapy vs chemoradiotherapy in the treatment of esophageal adenocarcinoma:A systematic review and meta-analysis

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World Journal of Gastroenterology 2024年第11期30卷 1621-1635页

作者： Armand csontos Alíz Fazekas Lajos Szakó Nelli Farkas csenge Papp Szilárd Ferenczi Szabolcs Bellyei Péter Hegyi András Papp department of surgery University of PécsMedical SchoolClinical CenterPécs H-7624BaranyaHungary Institute of Bioanalysis University of PécsMedical SchoolPécs H-7624BaranyaHungary Institute for Translational Medicine University of PécsMedical SchoolPécs H-7624BaranyaHungary department of Emergency Medicine Clinical CenterUniversity of PécsMedical SchoolPécs 7624BaranyaHungary department of Oncotherapy University of PécsMedical SchoolClinical CenterPécs H-7624BaranyaHungary Centre for Translational Medicine Semmelweis UniversityBudapest 1085Hungary Institute of Pancreatic Diseases Semmelweis UniversityBudapest H-1083Hungary

BACKGROUND Neoadjuvant therapy is an essential modality for reducing the clinical stage of esophageal cancer;however,the superiority of neoadjuvant chemotherapy(nCT)or neoadjuvant chemoradiotherapy(nCRT)is ***,a discussion of these two modalities is *** To investigate the benefits and complications of neoadjuvant *** To address this concern,predefined criteria were established using the PICO *** independent authors performed comprehensive searches using predetermined *** analyses were performed to identify significant differences between *** publication bias was visualized using funnel *** quality of the data was evaluated using the Risk of Bias Tool 2(RoB2)and the GRADE *** Ten articles,including 1928 patients,were included for the *** difference was detected in pathological complete response(pCR)[Pci:0.16-0.46],30-d mortality(P=0.015;OR:0.4;95%ci:0.22-0.71)favoring the nCRT,and renal failure(P=0.039;OR:1.04;95%ci:0.66-1.64)favoring the *** significant differences were observed in terms of survival,local or distal recurrence,or other clinical or surgical *** result of RoB2 was moderate,and that of the GRADE approach was low or very low in almost all *** Although nCRT may have a higher pCR rate,it does not translate to greater long-term ***,nCRT is associated with higher 30-d mortality,although the specific cause for postoperative complications could not be *** the case of nCT,toxic side effects are suspected,which can reduce the quality of *** the quality of available studies,further randomized trials are required.

关键词： Neoadjuvant Chemotherapy Chemoradiotherapy Esophageal cancer Adenocarcinoma

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Clinical and Therapeutic Aspects of Inguinal Hernia in Children in the general surgery department of reference Health Center in Commune I of Bamako Mali

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Surgical Science 2024年第2期15卷 54-63页

作者： Tounkara Cheickna Samake Hamidou Simpara Mama Diarra Issaka Sanogo Modibo Sidibe Souleymane Togola Modibo Dembele Bakary Tientigui Coulibaly Yacaria Togo Pierre Adégné Kante Lassana department of general surgery the Reference Health Center of Commune I Bamako Mali Directorate of Social Health Service the Armed Forces of Mali Bamako Mali department of Pediatric surgery Mali Hospital Bamako Mali department of general surgery the Gabriel TOURE University Hospital Bamako Mali department of Pediatric surgery Gabriel TOURE University Hospital Bamako Mali

Inguinal hernia in children is a congenital pathology in children linked to the persistence of the peritoneo-vaginal canal in children and the NüCK canal in girls;persisting into adulthood. This work aimed to study inguinal hernia in children in the general surgery department of the reference Health Center of Commune I of the Bamako District;to determine the frequency of inguinal hernia;describe the epidemiological, clinical and therapeutic aspects of inguinal hernias and in order to evaluate the cost of treatment. This was a prospective study from April 2017 to March 2018 during which 60 children with an inguinal hernia were collected. Inguinal hernias in children represented 9.23% of patients operated on in the department. The average age was 59.23 months with extremes of one month and 180 months and a standard deviation of 49.23 years. The male sex was dominant with a sex ratio equal to 9:1. The notion of prematurity was found in 11.7% and was associated with a testicle not in place in 1.7% of cases. 41.7% of our patients were referred by a doctor and 66.7% of patients presented with painless, intermittent inguino-scrotal swelling (83.3% of cases). The hernia was discovered before one week of life in 50% of cases. Inguinal swelling was absent in 11.7% but observed intraoperatively. The inguinal hernia was unilateral in 91.7% of cases and 70% of hernias were discovered by the parents during pushing efforts. The inguinal hernia was located on the right in 61.7% of cases. The hernia swelling was soft, painless, impulsive and reducible in 78.3% of cases. The swelling was inguino-scrotal in 58.3% of cases. The hernia was simple in 95% of patients and hernial strangulation was observed in 3 cases or 5% of cases. 98.3% of patients were ASA I. The treatment was carried out openly in all our patients including closure of the vaginal peritoneal canal in 95% of cases under general anesthesia in 98.3% of cases. The morbidity rate was 8.4% (surgical site infection: 6.7% of ca

关键词： Inguinal Hernia Child surgery cs ref C I Bamako Mali

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Epidemiological, Clinical, and Therapeutic Characteristics of Acute Appendicitis at the reference Health Center in Commune I of the District of Bamako Mali

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Surgical Science 2023年第10期14卷 637-645页

作者： Cheickna Tounkara Hamidou Samake Daye Kaloga Bagayoko Barthélémy Poudiougou Modibo Togola Sékou Koumare Bakary Tientigui Dembele Alhassane Traore Pierre Adégné Togo Lassana Kante Zimogo Zié Sanogo department of general surgery of cs ref ci Bamako Mali Directorate of the Social Health Service of Arms of Mali Bamako Mali department of general surgery CHU Point-G Bamako Mali department of general surgery of CHU Gabriel Touré Bamako Mali

Acute appendicitis is the most common abdominal surgical emergency. This work is a prospective study from January 2012 to December to analyze the epidemiological, clinical and therapeutic aspects of acute appendicitis in the cs ref of commune I of the district of Bamako and the results obtained were then compared with those reported in other countries. Our study included 72 patients. The appendectomy surgical specimens were the subject of an anatomical pathology study at Point G University Hospital in Bamako in Mali, 1.4% of cases of which were healthy. All our operated patients received antibiotics (mono or dual antibiotics) with a post-operative hospitalization duration of 1.5 (36 hours) days on average. We recorded 6 complications such as parietal suppuration, i.e. 8.33% of cases. No 5th day syndrome or late complications were noted. The average length of hospitalization was 36 hours. Abdominal ultrasound;used as an additional examination was carried out in 55 of our patients or 76.39% of cases. We have not recorded any deaths. Raising awareness among patients about the dangers of complications motivated patients to undergo surgery as soon as possible.

关键词： Acute Appendicitis Epidemiology Clinic and Therapy surgery csref ci Mali

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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 Dembele 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

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Acute Peritonitis at the reference Health Center of Commune I of the District of Bamako: Epidemiological, Clinical and Therapeutic Aspects

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Surgical Science 2023年第12期14卷 728-737页

作者： Tounkara Cheickna Samake Hamidou Maïga Amadou cisse Alou Hamadoun Diarra Issaka Sanogo Modibo Togola Modibo Dembele Bakary Tientigui Traore Alhassane Togo Pierre Adegne Kante Lassana department of general surgery Cs Ref of Commune I of Bamako Bamako Mali Central Directorate of Social Service of Army Health Bamako Mali department of general surgery Gabriel Toure University Hospital Bamako Mali

Acute peritonitis is most often secondary to perforation of the digestive organ and/or the spread of an intra-abdominal septic focus. The objectives of this work were to study acute peritonitis in the general surgery department of the cs ref of commune I in Mali, to determine the frequency of peritonitis, to describe the epidemiological, clinical and therapeutic aspects in order to analyze the surgical consequences and to assess the additional cost of treating acute peritonitis. This study was prospective, descriptive, cross-sectional involving 40 patients received in the surgery department of the cs ref of commune I for acute peritonitis from January 1, 2018 to December 31, 2018. There were 40 patients among whom 28 (70%) were men and 12 were women (30%), i.e. a sex ratio = 2.3. The average age was 25 years with extremes varying between 16 and 54 years and a standard deviation of 11.78. Abdominal pain was the main reason for consultation. Clinical examination alone made it possible to make the diagnosis in 75% of cases. Surgical treatment depended on the intraoperative etiology. The clinical diagnosis was supported by ASP and abdominal ultrasound;performed respectively in 10% and 90% of patients. Appendiceal peritonitis was the intraoperative diagnosis observed in 50% of cases. All our patients benefited from a peritoneal toilet with drainage. We noted a morbidity rate of 5% dominated by parietal suppuration. The average cost of care was 175,000 FCFA.

关键词： Acute Peritonitis Epidemiology Diagnostic Therapy Surgical Emergencies cs ref ci Bamako Mali

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Liver Abscesses in general surgery at csref ci in Bamako Mali

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Surgical Science 2023年第9期14卷 590-597页

作者： Cheickna Tounkara Hamidou Samake Bambaké Dembele Modibo Togola Bakary Tientigui Dembele Alhassane Traore Pierre Adégné Togo Lassana Kante department of general surgery of the cs ref of Commune I of Bamako Bamako Mali Directorate of Social and Health Service of the Armed Forces Mali Bamako Mali department of general surgery of the CHU Gabriel TOURE of Bamako Bamako Mali

Liver abscesses correspond to a newly formed cavity created by necrosis of the liver parenchyma induced by the pathogen. The aim of the present work was to study liver abscesses;determine the frequency;describe the clinical and paraclinical aspects, therapeutic and evolutionary modalities;determine the follow-up of treatment in order to assess the cost of treatment in the reference Health Center of Commune I of Bamako in Mali. This prospective study, involving 30 cases of liver abscess, took place over a period of 24 months from January 2015 to December 2016 in the general surgery department of the cs ref of commune I. The liver abscess is very often the consequence of amoebiasis which is rampant in the underprivileged population and it remains topical in surgical practice in Mali. Our hospital frequency was 0.081% with an average age of 34.40 years and extremes of 16 and 61 years;a sex ratio of 2.3 in favor of men. The main clinical signs were fever (56.7%), hepatalgia (73.3%) and hepatomegaly (26.7%). Hepatic collections objectified on abdominal ultrasound were located in the right lobe in 70% of cases and unique in 62%. Amebic serology carried out in 100% was negative in 20%;10% of cases had undergone surgical treatment. The consequences were simple for all our patients. The average cost of care, approximately 100,000 FCFA, was significantly higher than the minimum wage (28,460 FCFA) in Mali.

关键词： Liver Abscess Guided Ultrasound Puncture surgery Bamako Mali

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Effect of calcium supplementation on severe hypocalcemia in patients with secondary hyperparathyroidism after total parathyroidectomy

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World Journal of Clinical Cases 2022年第13期10卷 4033-4041页

作者： Jun Liu Xue-Feng Fan Meng Yang Lin-Ping Huang Ling Zhang department of general surgery China-Japan Friendship HospitalBeijing 100029China department of general surgery Shougang General HospitalShougang 553000Guizhou ProvinceChina department of Nephrology China-Japan Friendship HospitalBeijing 100029China

BACKGROUND Severe hypocalcemia(SH)is a dreaded complication of total parathyroidectomy(TPTX)without *** To compare conventional and preventive calcium supplementation(cs)regimens in terms of SH occurrence after *** This retrospective study included patients who underwent TPTX between January 2015 and May 2018 at the China-Japan Friendship *** January 2015 to May 2016,conventional cs was performed in patients who underwent TPTX,with calcium amounts adjusted according to postoperative serum calcium *** October 2016 to May 2018,preventive cs was performed according to preoperative alkaline phosphatase(ALP)*** patients were defined as lowrisk(ALP500 U/L)for *** preoperative blood samples were collected in the fasting state on the day before *** blood samples were obtained at 6-7 AM from the first postoperative *** A total of 271 patients were *** patients were 47.7±11.1 years old,and 57.6%were *** mean body mass index(BMI)was 22.9±3.8 kg/m^(2).There were no significant differences in sex,age,BMI,preoperative ALP,serum calcium,serum phosphorus,calcium-phosphorus ratio,and intact parathyroid hormone(iPTH)between the two cs *** with conventional cs,preventive cs led to lower occurrence rates of hypocalcemia within 48 h(46.0%vs 74.5%,Pci:1.000-1.001,P=0.009),preoperative ALP amounts(OR=1.002,95%ci:1.001-1.003,P=0.002),preoperative serum phosphorus levels(OR=8.729,95%ci:1.518-50.216,P=0.015)and preventive cs(OR=0.132,95%ci:0.067-0.261,Pciated with *** patients with preoperative ALP≥500 U/L,only preventive cs(OR=0.147,95%ci:0.038-0.562.P=0.005)was independently associated with *** This study suggests that preventive cs could reduce the occurrence of SH,indica

关键词： End-stage renal disease Secondary hyperparathyroidism Parathyroidectomy Hypocalcemia Calcium supplementation

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