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Breast Cancer in Young Women about 87 Cases in the General surgery department CHU Gabriel Touré

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 Dembélé Souleymane Samaké Moussa Keita Mory Dembélé 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

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Cancellation Causes of Elective Surgical Procedures in a Major Pediatric surgery department

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Open Journal of Pediatrics 2022年第1期12卷 131-136页

作者： Salsabil Mohamed Sabounji Mbaye Fall Cheikh Seye Mouhamadou Mansour Diene Gabriel Ngom Pediatric surgery department Albert Royer Children’s Hospital Dakar Senegal Pediatric surgery department Aristide Le Dantec Hospital Dakar Senegal Pediatric surgery department Heinrich Lubke Hospital Diourbel Senegal

Introduction: Cancellation of surgical operation is a surgical operation registered in the official schedule the day before or added to the list after and not carried out on the operating day. The purpose of this work was to determine the causes of cancellation of elective surgical operations in a major pediatric surgery department in Senegal. Patients and methods: It was a prospective and descriptive study of 278 patients scheduled during a period of 13 weeks. The study took place between April 3rd, 2017, and January 31st, 2018. Mean age was 2.9 years with extremes of 3 days and 15 years. The age group of 29 days to 30 months was the most represented (62.2%). Sex ratio was 1.41. Causes of cancellation were categorized into administrative and organizational causes, patient-related causes and staff-related causes. Results: Cancellation rate was 29.4%. Patient-related causes were most common (51.2%). Upper Respiratory tract infection (URTI) was commonest reason within this category (57.5%). Organizational causes (28.1%) came second and were mainly represented by the unavailability of the operating room (60.8%) related to breakdowns of anesthesia equipment. Finally, staff-related causes (20.7%) were due for most to the unavailability of the anesthesiologist (12 cases/17). Conclusion: Majority of causes that led to cancellation of elective surgical operations in our Pediatric surgery department are related to intercurrent illnesses affecting the patient, in particular URTI.

关键词： Cancellation Elective surgery URTI Pediatric surgery Surgical Procedures

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Post-Traumatic Pyothorax: Epidemiology, Management and Prognosis in the Thoracic surgery department of the Donka National Hospital

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Open Journal of Thoracic surgery 2021年第4期11卷 83-88页

作者： Camara Alpha Kabinet Camara Soriba Naby Balde Oumar Taibata Diallo Amadou Sarah Camara Mama Aissata Magassouba Aboubacar Sidiki Balde Abdoulaye Korse Toure Aboubacar Diallo Aissatou Taran Diallo Biro department of Thoracic surgery Donka National Hospital Conakry Guinea Faculty of Sciences and Technic of Health Gamal Abdel Nasser University of Conakry Conakry Guinea department of Visceral surgery Friendship Hospital Sino Guinean Conakry Guinea department of Visceral surgery Donka National Hospital Conakry Guinea department of General surgery Ignace Denn National Hospital Conakry Guinea

Pyothoraxes, also called thoracic empyemas, are defined by the presence between the two layers of the pleura, of a frankly purulent liquid, or of a shady or clear liquid but containing a majority of altered polynuclear cells with germs direct examination. They are said to be traumatic when they follow a thoracic trauma whatever the mechanism;usually a pre-existing post-traumatic pleural effusion. The general objective of this study was to help identify the epidemiological and prognostic factors in the management of post-traumatic pyothorax in the Thoracic Surgery Department of the Donka National Hospital. Methodology: This was a descriptive retrospective study covering a period of 2.5 years from 01/06/2016 to 31/12/2018 carried out in the Thoracic Surgery Department of the Donka National Hospital. Results: During the study period, 17 cases of post-traumatic pyothorax were observed among the 288 files of admitted and hospitalized patients. In the course of this study, a rate was 5.90%. The most affected age group was 1 to 5 years old. The male sex was in the majority (76.5%). The most common occurrence was the fall, i.e. 41.2%. 47% of patients consult after 60 days. Chest pain and dyspnea were the main symptoms during our study (82.3%). Antibiotics and analgesics dominated the medical treatment used in 100% of the cases and pleural drainage was the first line surgical treatment practiced in 88.2% of the cases. The prognosis is favorable without sequelae in 52.9% of cases with an average hospital stay

关键词： Pyothorax Trauma Epidemiology Management Prognosis surgery Donka

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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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Volvulus of Colon Sigmoide in the General surgery department of Chu Gabriel Toure

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Surgical Science 2022年第1期13卷 46-52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 Dembélé Souleymane Samaké Moussa Dembélé 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: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cause of colonic occlusion, it is characterized by strangulation of the sigmoid loop around its meso colic axis producing low mechanical occlusion [1]. Apart from this form conventionally described, the volvulus of the sigmoid colon can occur along an organoaxial axis. This form has been highlighted in the literature thanks to the diagnostic contribution of multi-detector scanners [2]. Objective: To determine the hospital frequency of sigmoid colon volvulus;to write the clinical and para-clinical aspects of sigmoid colon volvulus;write down the different treatments used for the management of sigmoid colon volvulus.

关键词： Sigmoid Volvulus General surgery department

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Pterygium Popliteal Syndrome Concerning a Case in the Pediatric surgery department of the Donka National Hospital (Conakry CHU)

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Open Journal of Pediatrics 2022年第1期12卷 162-169页

作者： Balla Keita Mamadou Alpha Toure Mohamed Lamie Sacko Mamadou Madiou Barry Mamadou Karamba Kaba Daniel Agbo-Panzo Pediatric surgery department CHU Donka Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea Plastic surgery department CHU Donka Conakry Guinea

Introduction: Popliteal pterygium syndrome is a rare birth defect, combining craniofacial, genitourinary and musculoskeletal abnormalities. It is an autosomal dominant disease caused by a mutation in the IRF6 gene. We report in this observation the 1st Guinean case corrected by the surgical method as well as a review of the literature for a diagnostic and therapeutic approach. Patient and observation: We present the case of a 7-day old male newborn weighing 2700 g who was received for bilateral cleft lip and palate, lower lip fossa or sinuses, bilateral popliteal pterygium, and triangular skin fold above the hallux. The patient underwent several surgical procedures aimed at correcting these abnormalities. The correction of the pterygium of the lower limbs was ensured by excision of the fibrous band, the tenoplasty in z of the calcaneal tendon on the right side and the skin plasty in z in series then immobilized by plaster splints. The immediate postoperative follow-up was straightforward. Conclusion: Popliteal pterygium syndrome is a rare congenital malformation, the diagnosis is primarily clinical. Early soft tissue lengthening surgery and serial z-skin plasty provide better correction of the knee pterygium. Correct correction of facial abnormalities gives the child a better appearance. The management of this syndrome is multidisciplinary.

关键词： Popliteal Pterygium Congenital Malformation Genetic Disease Pediatric surgery Multidisciplinary Team

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The Lithiasis of Choledoque: Epidemiological Aspects, Clinics and Therapeutiques in the surgery department “A” at the University Hospital Point G

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Surgical Science 2019年第8期10卷 281-286页

作者： O. Sacko S. Diallo L. Soumaré M. Camara S. Koumaré M. Sissoko S. Keita I. Diarra M. Konaté M. Traoré G. Soumaré D. Dakouo M. Coulibaly H. Dicko Y. Dianessi A. Koita Z. Sanogo department of surgery “A” University Hospital of Point G Bamako Mali department of surgery “B” University Hospital of Point G Bamako Mali department of surgery Reference Center of Town 6 Bamako Mali department of Gynecology-Obstetrics University Hospital of Point G Bamako Mali department of Intensive Care University Hospital of Point G Bamako Mali

Considered as rare in Africa lithiasis of the main bile duct (MBD) is a potentially serious pathology, diagnosis is facilitated by imaging tests (ultra-sound, CT, MRI cholangiopancreatography). Its surgical management is improved by laparoscopy coupled with interventional endoscopy. However, laparotomy remains the only way in Mali. This was a 14-years retrospective and descriptive study (2010-2014). All patients with BPV lithiasis were included. We studied the field, antecedents, clinical, biological, radiological, therapeutic and outcome aspects. 40 cases of stones in the main bile duct were collected during the study period. The hospital frequency was 2.8 cases per year, the clinical signs dominated by the Charcot triad (pain, fever, jaundice) found in 40 cases (100%). The average age was 60 years, female represented 70% of cases. Ultrasonography was the most requested review in 40 cases (100%). The procedure performed was cholecystectomy associated with choledochotomy with calculation extraction in all patients (100% of cases). One case of biliary fistula and one case of wall abscess were observed. The mortality was 5% and the simple suited in 90% of the cases. The lithiasis of the main bile duct is an infrequent pathology in Mali and potentially serious. This diagnosis is assisted in our context by ultrasound and CT. Laparotomy remains the only route of entry in Mali.

关键词： Lithiasis of the CBD surgery Cholodochotomy

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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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Hydatid Cyst of the Liver: About a Case at the Digestive and General surgery department of the University Hospital of Bouaké(Côte d’Ivoire)

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Surgical Science 2023年第1期14卷 10-16页

作者： Leh Bi Kalou Ismaèl N’Dri Ahou Bernadette Ekra Amos Serge Kouakou Blaise Amos Bamba Inza Kouakou Kouamé Bernardin Anzoua Kouakou Ibrahim Traore Mamadou Lebeau Roger Diané Bamourou department of General and Digestive surgery CHU of Bouaké Bouake Ivory Coast

Hydatid cyst of the liver (KHF) is a parasitic condition caused by the development of the larval form of the dog tapenia Echinococcus granulosus. In sub-Saharan Africa, few writings are interested in this pathology, which remains common and constitutes a public health problem in highly endemic countries [1] [2]. We report the observation of a 61-year-old hypertensive patient owner of a dog admitted for abdominal pain without abdominal mass. In whom ultrasound and computed tomography have made it possible to make the diagnosis of hydatid cyst of the liver (KHF). The patient underwent surgery. We performed an associated conservative treatment post-operative albendazole. The post-operative follow-up was simple. In our patient the evolution was good after a setback of more than 2 months. Through this observation and a review of the literature, we insist on the contribution of imaging in diagnosis and treatment, which is essentially surgical.

关键词： Liver Hydatid Cyst Diagnosis Treatment

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Reasons for Elective surgery Cancellations in a Senegalese Pediatric surgery department

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Open Journal of Pediatrics 2024年第5期14卷 783-789页

作者： Cheikh Tidiane Mbaye Cheikh Diouf Florent Tshibwid A Zeng Faty Balla Lô Lissoune Cissé Doudou Gueye Ibrahima Bocar Wellé Souleymane Camara Papa Alassane Mbaye Oumar Ndour Gabriel Ngom department of Pediatric surgery Aristide Le Dantec University Teaching Hospital Universit Cheikh Anta Diop Dakar Senegal department of Pediatric surgery Ziguinchor Regional Hospital Center Universit Cheikh Anta Diop Ziguinchor Senegal department of Pediatric surgery El Hadj Ibrahima Niass Regional Hospital Center Kaolack Senegal department of Pediatric surgery Pikine National Hospital Center Dakar Senegal department of Pediatric surgery Albert Royer National Childrens Hospital Center Universit Cheikh Anta Diop Dakar Senegal Unit of Pediatric surgery Department of Pediatrics Dalal Jamm National Hospital Center Dakar Senegal

Introduction: Cancellation of elective surgery is common in developing countries. This decision is difficult to make as it generates economic and organizational consequences for the healthcare facility and an additional source of stress for patients and their caregivers. This study aimed to analyze the various aspects of this medical problem. Patients and Methods: We conducted a prospective and descriptive study over six months (from January 1st, 2017, to June 30th, 2017) at the pediatric surgery department of Aristide Le Dantec University Teaching Hospital in Senegal. Results: Ninety-one cases were collected. The cancellation rate was 20.8%. Infants were affected in 36.3% of cases. Among anesthesiologists, 83.5% were residents, and 16.5% were specialists. Cancellation in nephroblastoma children with an indication for extended nephrectomy represented 15.4% of cases. Concerning reasons for cancellation, comorbidities, dominated by respiratory infections, accounted for 28.5% of cases, patient absences for 24.2%, and issues related to the anesthesiologist for 17.6%. Cancellations were avoidable in 33% of cases. Patients were responsible for cancellation in 37.4% of cases, the healthcare system in 33%, and medical reasons in 29.7%. Conclusion: Our findings suggest that one-third of cancellations could have been avoided with improvements in the healthcare system. Actions should be taken to reduce the cancellation rate in our context.

关键词： Cancellation Elective surgery Pediatric surgery LMICs Senegal

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