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Clinical outcomes and ergonomics analysis of three laparoscopic techniques for Hirschsprung's disease

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World Journal of Gastroenterology 2015年第29期21卷 8903-8911页

作者： Tajammool Hussein Aubdoollah Kang Li Xi Zhang Shuai Li Li Yang Hai-Yan Lei Ponnie Robertlee dolo Xian-Cai Xiang Guo-Qing Cao Guo-Bin Wang Shao-Tao Tang department of Pediatric surgery Union Hospital Tongji Medical College Huazhong University of Science and Technology

AIM: To report the clinical outcomes and ergonomics analysis of three laparoscopic approaches in the management of Hirschsprung's disease(HD).METHODS: There were 90 pediatric patients(63 boys, 27 girls; mean age: 3.6 ± 2.7 mo; range: 1.0-90.2 mo) who underwent laparoscopic endorectal pull-through Soave procedures for short- and long-segment HD in our hospital. Three laparoscopic approaches were used: conventional laparoscopic pull-through(CLP) in 30 patients between 2009 and 2013, single-incision laparoscopic pull-through(SILP) in 28 patients between 2010 and 2013, and hybrid single-incision laparoscopic pull-through(H-SILP) in 32 patients between 2011 and 2013. We applied the hybrid version of the single-incision approach in 2011 to preserve the cosmetic advantage of SILP and the ergonomic advantage of CLP. We retrospectively analyzed the clinical data, cosmetic results, and ergonomics of these three approaches to have a better understanding of the selection of one approach over another. RESULTS: The CLP, SILP, and H-SILP groups were similar in regard to age, sex, transition zone, blood loss, hospital stay, and intraoperative complications. Early and late postoperative results were not different, with equal daily defecation frequency and postoperative complications. No conversion to open technique was needed and none of the patients had recurrent constipation. With proper training, the ergonomics challenges were overcome and similar operative times were registered for the general operative time in the patients 1 year of age(CLP and H-SILP: 120 ± 15 min and 119 ± 12 min, respectively, vs 140 ± 7 min; P < 0.05) and for long-segment HD patients(152 ± 3.5 min and 154 ± 3.6 min, respectively, vs 176 ± 2.3 min; P < 0.05). The best cosmetic result was registered with the SILP(scarless), followed by the H-SILP(near scarless appea

关键词： Age Cosmetic Ergonomic hirschsprung'sdisease Laparoscopic pull-through

Prevalence of Ocular Trauma at the Reference Health Center (CSREF) of Kati

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Surgical Science 2024年第5期15卷 371-380页

作者： Kadiatou Ba Aichata Tall Brainima Coulibaly Sadio Cissoko Bakary Danfaga Moro Sidibe Seydou Diallo Oumar Diallo Fatoumata Tata Sidibe Aly Konipo Mory Coulibaly Ousmane Touré Aoua I. Touré Cheick Sogodogo Ibrahim Bamenta Gounon Saye Modibo Sissoko Mamadou Kole Sidibe Sidi Diarra Nouhoum Guirou Lamine Traoré University hospital Center Institute of Tropical Ophthalmology of Africa Bamako Bamako Mali Ophthalmology department Kati Reference Health Center Koulikoro Mali Ophthalmology department Sikasso Regional Hospital Sikasso Mali Ophthalmology department Luxembourg Mother-Child Hospital in Bamako Bamako Mali Ophthalmology department Somin&#233 Dolo Mopti Regional Hospital in Mopti Mopti Mali National Eye Health Program Bamako Mali

Introduction: The authors wanted to study the prevalence of ocular trauma in the ophthalmology unit of the CSREF of Kati. Patients and method: This is a retrospective study, covering the period from January to December 2015, carried out in the ophthalmology unit of the CSREF in Kati. Results: The sample consisted of 568 patients, or 6.82% of ophthalmological consultations. Children aged 0 to 14 years accounted for 154 (27.11%) of the trauma cases. Bruises constitute the main circumstance (58.1%) of eye trauma, followed by domestic accidents (15.6%). Closed globe ocular trauma was the main type of trauma (61.6%), followed by ocular adnexal trauma (30.1%) and open globe trauma (8.3%) in which the penetrating wound was the lesion, the least common (2.6%) but the most serious. Medical treatment was the most used therapeutic modality in 82.4% of cases, followed by surgery with 17.6% of cases. The evolution of the lesions after treatment was favorable in 85.6% of cases and unfavorable in 14.4% of cases. Complications were observed in 5.8% of cases and sequelae in 8.6% of cases. Conclusion: Ocular trauma constitutes an important reason for ophthalmological consultation at the CSREF of Kati. The severity of some of these lesions requires frequent recourse to surgery. The complexity of the treatment should encourage us to favor preventive measures.

关键词： Eye Trauma Prevalence CSREF Kati

Usefulness of a Clinico-Biological Francois’Score in the Diagnosis of Acute Appendicitis:Experience of the University hospital Center of Parakou,Benin

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Surgical Science 2018年第3期9卷 91-96页

作者： Montcho Adrien Hodonou Bio Tamou-Sambo Salako Alexandre Allode Roméo Romaric Gbédolo Djifid Morel Séto Selome Romaric Tobome Moise Francis Dossou Dodji Emile Mensah department of surgery and Specialties Teaching HospitalMedicine SchoolUniversity of ParakouParakouBenin Saint John of God hospital Center of Tanguieta TanguietaBenin Teaching hospital of Porto-Novo Faculty of Health ScienceUniversity of Abomey CalaviCotonouBenin

Introduction: Diagnostic wanderings of acute appendicitis are responsible for serious complications or abusive appendectomies. Existing Clinico-biological scores are efficient. Objective: To determine the diagnostic efficiency of Fran?ois’ score in acute appendicitis. Methodology: over 10 months, all the patients admitted in the CHUD-Parakou Emergency department for pain in the right iliac fossa had been examined by resident students who calculated Fran?ois’ score. After verification by the surgeon, patients were put into three categories: category 1 score ≥ 2;category 2, score between -6 and 2;category 3, score below -6. Sensitivity and specificity were calculated. Results: out of 54 patients selected (29 men and 25 women), 29 were classified as group 1;19 as group 2 and 6 as group 3. An ultrasound was performed in all patients in group 2, and signs in favor of appendicitis were found in 12 patients. Of the 41 appendicectomies performed, the histologic analysis of 33 operative specimens found a pathological appendix. Sensitivity, specificity and negative predictive value per group were 100%. It has prevented almost in one every four patients (24.07%) an abusive appendectomy. Conclusion: This score would reduce diagnostic wanderings and target patient groups for imaging studies.

关键词： Acute Appendicitis Francois Score Sensitivity Specificity Resource-Limited Countries

Study of Malaria in Patients Operated on at the Reference Health Center of Commune I Bamako

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Surgical Science 2023年第9期14卷 598-607页

作者： Tounkara Cheickna Samaké Hamidou Koné Abdoulaye Maiga Boubacar Diarra Yaya Kayentao Kassoum dolo Amadou Diallo Mouctar department of general surgery of the Reference Health Center of Commune I Bamako Mali Directorate of Social and Health Services of the Armed Forces of Mali Bamako Mali University of Sciences Techniques and Technologies of Bamako (USTTB) Mali Bamako Mali

Malaria is a febrile and hemolyzing erythrocytopathy due to the development and multiplication of one or more of the five plasmodial species dependent on humans: Plasmodium falciparum, P. malariae, P. ovale, P. vivax and P. knowlesi. These parasites are inoculated into humans by the infective bite of a female mosquito, female anopheles of the genus Anopheles, during a blood meal. The study aimed to: determine the frequency of fever due to malaria after surgery;describe malaria symptomatology and clinical evolution after surgical intervention;determine the average length of hospital stay for operated patients with malaria;evaluate the average cost of malaria treatment. This was a prospective study which involved 110 operated patients, which took place over a period of 12 months from March 2017 to February 2018 in the general surgery department at the Reference Health Center of commune I of the Bamako district. The frequency of malaria was 11.82% before the intervention and 3.64% after the intervention, with an average age of 29.80 years;extremes of 2 years and 76 years and a sex ratio of 1.5 in favor of the male sex. The main clinical signs were fever (38.18%), headache (20.91%) and vomiting (36.36%) and physical asthenia (18.18%). Diagnosed and treated early, malaria progressed favorably. The outcome was simple for all our patients and we did not record any deaths. The cost of treatment was borne by the patients and/or their families. The average cost of treatment was 7915 CFA francs, significantly below the Malian minimum wage which is around 30,000 FCFA. The implementation of preventive measures is necessary to reduce the importance of malaria in hospitals: staff awareness, indoor spraying, use of impregnated mosquito nets.

关键词： Malaria Plasmodium surgery Fever Thick Gout Rapid Diagnostic Test

Management and Prognosis of Early Postpartum Hemorrhage in African Low Setting Health

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Open Journal of Obstetrics and Gynecology 2018年第1期8卷 1-9页

作者： Youssouf Traoré Ibrahima Téguété Amadou Bocoum Mamadou Traoré Seydou Dao Marion Koko Bomini Niani Mounkoro Amadou dolo department of Gynecology and Obstetrics Gabriel Touré Teaching Hospital Bamako Mali department of Gynecology and Obstetrics Yopougon Teaching Hospital Abidjan Cote d’Ivoire

Early postpartum hemorrhage is one of the major causes of maternal death in the world especially in developing countries. Its management often relieves resuscitation that is often difficult to set up in our countries and sometimes based on invasive and mutilate surgery. Objectives: The purpose of this survey was to report frequency of this pathology, to describe its management and the factors that influence the prognosis of early postpartum hemorrhage in low setting health in Africa. Method: Authors conducted a prospective study that analyzed early postpartum hemorrhage in the motherhoods of Gabriel Touré teaching hospital and community five health reference center of the district of Bamako. It took place from January, 2015 to December, 2016. The study concerned all the cases of early postpartum hemorrhage according to WHO definition. Statistical tests used were X2 or Fisher test, its 95% confidence interval (CI95%), p value was significant if Results: Early postpartum hemorrhage frequency has been 0.7% (62 cases for 8.885 deliveries). Sixty nine and one percent (69.1%) of patients have been blood fluid transfused. Obstetric treatment dominated by uterine revision (30.7%). Hysterorraphy (4.0%), hysterectomy (3.0%), suture of uterus injuries (15.7%), hypo gastric artery ligature (2.0%) and B-Lynch compression suture (2.0%) have been the main practiced surgical operations. No satisfy blood transfusion need was 26.9%. The main risk factors of early PPH were high parity (p = 0009;RR = 3.04;CI95% [2.80 - 5.11]), prolonged labor (p = 0004;RR = 4.00;CI95% [3.06 - 10.02]), oxytocin/prostaglandin use (p = 0003;RR = 1.47;CI95% [1.17 - 3.16]). Eleven of maternal occurred (11.8%). Conclusion: Early postpartum hemorrhage is still a severe event in developing countries especially. Its management sometime consisted to invasive cares. Maternal prognosis that is influenced by unsatisfied blood need and late management is marked by high lethality.

关键词： Early Postpartum Hemorrhage Risk Factors surgery Maternal Death

Emergency C-Section on Multi-Scar Uterus: Maternal and Fetal Prognosis at the Nianankoro Fomba hospital in Segou, Mali

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Open Journal of Obstetrics and Gynecology 2023年第5期13卷 997-1005页

作者： Tidiani Traoré Seydou Traoré Seydou Z. Dao Abdoul K. Ballo Kassoum Sidibé Brahima Donigolo Babou Traoré Famakan Kané Adama Coulibaly Abdrahamane Diarisso Alima Sidibé Adama Camara Yacouba Dembélé Thierno Boubacar Bagayoko Alpha Sanogo Adama Bah Abdoulaye Kassogue Hamidou Toungara Seydina Alioun Beye Agoustin Thera Youssou Traoré Ibrahima Teguété Niani Mounkoro Amadou dolo Gynecology department of hospital Nianankoro Fomba Segou Mali Gynecology department of Reference Health Center of Koutiala Koutiala Mali Gynecology department of Reference Health Center of Commune II of Bamako Bamako Mali Gynecology department of Reference Health Center of Bla Bla Mali Gynecology department of Reference Health Center of Kayes Kayes Mali Gynecology department of Reference Health Center of Commune V of Bamako Bamako Mali Gynecology department of Reference Health Center of Sikasso Sikasso Mali Gynecology department of Mohamed VI Polyclinic of Bamako Bamako Mali Gynecology department of Point G Teaching hospital Bamako Mali Gynecology department of Gabriel Touré Teaching hospital Bamako Mali Gynecology department of Pasteur Clinic of Bamako Bamako Mali

Background: Multi-scar uterus is a uterus with two or more scars due to surgery or trauma. Objective: The aim was to compare the maternal and fetal prognosis of emergency C-sections of bi-scar uteruses to those of uteruses with at least 3 scars at the Nianankoro Fomba hospital in Segou. Materials and Methods: It was a descriptive and analytical cross-sectional study with prospective data collection over a 24-month period from March 20, 2018, to March 20, 2020. Results: In 2 years, we collected 103 emergency C-sections for multi-scar uterus out of 1198 C-sections with a frequency of 8.6%. The age group of 20 to 35 years was the most represented with 86.4%. The bi-scar uteruses were the most frequent with 77.7%. In 71.8% of cases, the C-section was performed during the latent phase of labor. The C-section was performed under loco-regional anesthesia in 89.3% of cases. Difficulties in hemostasis and bladder injury were the most frequent intraoperative accidents. Surgical site infection was the main postoperative complication. No maternal deaths were recorded. The perinatal prognosis was marked by 4.3% fresh stillbirths in bi-scar uterus against 3.7% in three or more scar uteruses and including 2 fresh stillbirths and 1 macerated. We did not record any early neonatal deaths after C-section. Conclusion: The frequency of emergency C-sections in patients with a multi-scar uterus remains very high in our hospital. A better awareness of the patients, their spouses and all the actors involved in the management of pregnancies and childbirth, can contribute to curb this trend.

关键词： C-Section Prognosis Segou Multi-Scar Uterus Emergency

Prognosis of Pregnancy and Childbirth in Heart Operated Patients: Experience in a 3 Referral hospital in Mali, Case of the Gabriel University hospital in Bamako

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Open Journal of Obstetrics and Gynecology 2021年第12期11卷 1875-1887页

作者： Fané Seydou Sanogo Siaka Amara Bocoum Amadou Sylla Checkna Kante Ibrahima Traore Youssouf Tegueté Ibrahima M. Traoré Mounkoro Niani A. dolo UTH Gabriel Toure Bamako Mali Point G hospital Teaching Bamako Mali

Introduction: In sub-Saharan Africa and Mali, young women who have had heart surgery want to become pregnant. The occurrence of pregnancy in these women who have had heart surgery is becoming more and more frequent in our country because of the persistence of acute rheumatoid arthritis (RAA) and especially the increasingly easy access to heart surgery. General Objective: To study the evolution of pregnancy and the prognosis of childbirth in women who have undergone heart surgery. Methodology: This was a retrospective and descriptive study that took place over a period of five (5) years in the gynecology-obstetrics department of University Teaching Hospital (UTH) Gabriel Touré and the cardiology department of UTH Luxembourg. Was included in the study any pregnant woman admitted to the gynecology-obstetrics department of UTH Gabriel Touré and having a history of heart surgery. The variables studied were the socio-demographic characteristics, the type of heart disease, the management, the evolution of the pregnancy and the prognosis. Data was typed on word processor, Excel and analyzed on Epi info and SPSS. The Chi square or Fisher exact test (for the number

关键词： Cardiac surgery Pregnancy Prognosis