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AIM: To determine the frequency of the surgery wound infection, its favoring factors, causative germs and its antibiotic treatment of choice in the surgery "A" department of the University Hospital Point G. Method: In a retrospective descriptive study over a 6-month period in the surgery "A" department of the University Hospital Point G, we enrolled all patients who underwent surgery necessitating at least 48 hours of hospital admission during our study period and in conformity with the Atlanta CDC criteria. Surgery patients with less than 48 hours postoperative hospital stay and those admitted to the hospital without surgery were not included. After the surgery, the nature and location of the infection have been clarified. In this work, ethical considerations have been respected and there is no conflict of interest. Results: Two hundred and sixty-five (n=265) patient files were collected including 24 cases of surgery wound infection (a hospital frequency of 9%. The average age was 41.41 years (y.o) old with extremes of 7 y.o and 102 y.o. The sex ratio was 0.9 in favor of women. The commonly studied pathologies were digestive surgery in 52.8%, gynecological surgery in 24.5%, etc... Patients were seen in regular outpatient surgery visits in 75.8% and surgical emergencies in 24.2%. Of the patients urgently admitted, 26.5% presented an ISO; for those received in ordinary consultation it was 3.48%. Fifteen (15) cases were classified ASA III and two (2) ASA II. Based on the Altemeier classification, surgery was clean in 66.8% of our patients, contaminated clean in 12.4%, contaminated in 12.1%, and dirty in 8.7% (including half resulting in surgery wound infection). In total, 79% of patients whose surgeries lasted more than two (2) hours presented a surgery wound infection. Postoperative infection of patients was superficial in 58.3% and deep in 33.3%. In 8.3% of cases, it was a space infection. At the cytobacteriological examination of the pus from the operative site, Escherichia coli (E. coli) was the most common germ with 58.3%. E. coli was sensitive to amoxicillin-clavulanic acid in 57.14%. Surgically, a re-intervention was performed in 20.8% of cases, a secondary suture in 12.5%, and a single dressing in 66.7%. The average postoperative stay was 6.5 days with extremes of 2 days and 69 days. In 3 months postoperatively we recorded 4 cases of death. Conclusion: The surgery wound infection constitutes a major complication in a surgical environment starting with surgical act itself. Particular emphasis should be placed on prevention, which will reduce the risks of ISO occurrence. [ABSTRACT FROM AUTHOR]

Goal: To evaluate the diagnosis and therapeutic aspects of the amoebic liver abscesses in the surgery« A» department of hospital du Point "G". Patients and methods: Were included in this study, patients admitted to surgery« A » department for amoebic liver abscess on the basis of amoebic serology, chocolate appearance of pus and absence of bacteria in the pus. Bacterial liver abscesses were excluded from this study. Results: Over a period of 10 years, 52 cases of patients diagnosed with amoebic liver abscess were collected in the department. There were 41 men and 11 women, with a sex ratio of 3,7. The medium age of the patients was 37.8 years with extremes of 15 years and 66 years. The most represented occupations were farmers (36.5%) followed by traders (26.7%) and students (11.5%). The average consultation time was 18.5 days (rate 5 days and 34 days). The most frequent clinical signs were pain in the right hypochondrium (86.5%), fever (78.8%) and hepatomegaly (61.5%). Abdominal ultrasound showed a single located abscess in 44 cases (84.6%) and these abscesses were localized in the right hepatic lobe in 34 cases (65.4%). The medium volume of the abscess was 366.5 cm3with the extremes of 36 cm3 and 1580 cm3. Amoebic serology was positive in 80.9%of patients (n = 38). Cytobacteriological analysis of pus in 37 cases (n = 71%) was negative. An ultrasound assisted needle aspiration of pus was performed in 65.4% of patients. The surgical procedure by laparotomy was performed in 7.7% of cases and a laparoscopic approach in 5.8%. The clinical course was uneventfulin 94.2%. The mean hospital stay was 16.5 days with extremes of 4 days and 29 days. No deaths were recorded during hospitalization. Conclusion: Amoebic liver abscess is an uncommon pathology in surgical setting. Abdominal ultrasound and puncture guided by echography allowed the diagnosis. Laparoscopic treatment minimizes the inconvenience of laparotomy. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the surgical treatment of goiter in the «A» surgical department of the University Hospital Point G in Bamako. Patients and Methods: This was a retrospective and descriptive study in the «A» surgical department of the University Hospital POINT G from January 2007 to August 2014. Were included in the study all the patients operated for goiter. The patients who underwent surgery for other thyroid diseases were not selected. Postoperatively patients were followed for one year. The sociodemographic, clinical, para-clinical, therapeutic aspects and the postoperative course were the study parameters. Data analysis was performed on SPSS 21. The Chi square test was used for the statistical analysis. A p-value inferior to 0.05 was considered statistically significant. Results: A total of 378 patient's records were collected. Thyroidectomy represented 6.2% (378 cases) over 6027 operations. The mean age was 41.29 years with a standard deviation of 13.58. Extreme were 3 and 85 years. The sex ratio was 7.22 in favor of women. The frequent reason for consultation was the antero-cervical tumor with 97.07% of cases (n = 367). We identified 118 cases (31.22%) of goiter in cooled hyperthyroidism patients, 211 cases (55.82%) of euthyroid goiter, 7 cases (1.85%) of the thyroid neoplasia and one case (0.3%) of hypothyroidism goiter. Pathological histology helped to highlight a micro-vesicular macro adenoma in 16.1% of cases (61 patients); adenocarcinoma in 0.7% of cases (3 patients) and papillary carcinoma in 1.1% of patients (4 patients). The patients classify ASA I and ASA II represented the majority with respectively 248 cases (65.60%) and 120 cases (31.74%). The most performed surgical techniques were subtotal thyroidectomy (n=181; 49.7%), the isthmo-lobectomy (126; 33.3%), total thyroidectomy (n=11; 2.9%) and sternotomy in one case of endothoracic goiter. Intraoperative complications were marked by hemorrhage in 12.7% of cases (45 patients). The postoperative one month follow up was uneventful in 91.79% (n = 347) and transient recurrent nerve injury was found in 2% of cases (1 patient). In one year follow up the postoperative outcome was good in 94.17% (n = 356) of patients. The mean hospital stay was 4.18 days. Six deaths were recorded (1.7%). Conclusion: Goiter surgery is relatively common in the surgery 'A' department of Point G University hospital. Good patient's preparation and a better postoperative monitoring could help to minimize postoperative complications. [ABSTRACT FROM AUTHOR]

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Mali Médical is the property of Mali Medical, Faculte de Medecine, de Pharmacie et d'Odonto-stomatologie and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: toutes les sténoses symptomatiques de l'ésophage peuvent être dilatées par voie endoscopique. Nous évaluons l'apport des moyens endoscopiques dans la prise en charge de la dilatation ésophagienne pour sténose caustique de l'ésophage (SCO) au Mali. METHODES: il s'agissait d'une étude descriptive et prospective réalisée dans le service de chirurgie thoracique à l'hôpital du Mali. Au total 46 dossiers cliniques de patients on été enregistrés et subdivisés en 4 groupes en fonction de la topographie des lésions cicatricielles. Le nombre de cas d'assistance endoscopique réalisé a été déterminé afin de comprendre l'apport des moyens endoscopiques dans le succès de la dilatation des SCO. Pour les 2 différentes méthodes de dilatation utilisées, le résultat du traitement et le coût ont comparés.RESULTATS: la FOGD a été utilisée dans 19 cas (41.30%) de dilatation avec la bougie de Savary Guillard et dans 47.82% des cas dans la dilatation de Lerut. La vidéo-laryngoscopie a été utilisé 58.69% des cas de dilatation à la bougie de Lerut. Le passage de guide métallique et / ou de fil-guide a été réalisée dans 39.13% avec la vidéo laryngoscopie et dans 58.68% avec la FOGD. Dans la comparaison des deux méthodes, il existe une différence significative dans la survenue des complications (p=0.04075), l'anesthésie générale (p=0.02287), l'accessibilité à la méthode (p=0.04805) et la mortalité (p=0.00402). CONCLUSION: la SCO est une pathologie grave et sous évaluée au Mali. Les moyens endoscopiques contribuent considérablement au succès de la dilatation �sophagienne pour sténose caustique dans les différentes méthodes utilisées.

Endoscopic surgery of ectopic pregnancy is actually the gold standard for the management of fallopian tubal diseases. A survey was conducted to evaluate fertility in patients who underwent endoscopic management for ectopic pregnancy. A retrospective study was conducted at the department of general and endoscopic surgery of the Point "G" teaching hospital, in Bamako, Mali, from January 1st 2007 to December 31, 2016. Forty-eight (48) patients who underwent endoscopic management of tubal ectopic pregnancy and who have been followed up for fertility were included in this study. Statistical tests used were X2 or Fisher test and their confident interval, p <1 % has been considered as statistically significant. The therapeutic score of Pouly was less than 4 in 25.0% (n = 12). The return to fertility was observed among 48.0% of patients (n = 23). The chance of conception was less than 80.0% after the fourth postoperative year (p=0.001). The outcome of pregnancies has been seventeen full-term pregnancies, three ectopic pregnancies and three miscarriages. The occurrence of pregnancy after endoscopic management indicated for ectopic pregnancy is possible. However, many factors can influence the future conception.

Aim: To determine the frequency of the surgery wound infection, its favoring factors, causative germs and its antibiotic treatment of choice in the surgery "A" department of the University Hospital Point G., Method: In a retrospective descriptive study over a 6-month period in the surgery "A" department of the University Hospital Point G, we enrolled all patients who underwent surgery necessitating at least 48 hours of hospital admission during our study period and in conformity with the Atlanta CDC criteria. Surgery patients with less than 48 hours postoperative hospital stay and those admitted to the hospital without surgery were not included.After the surgery, the nature and location of the infection have been clarified. In this work, ethical considerations have been respected and there is no conflict of interest., Results: Two hundred and sixty-five (n=265) patient files were collected including 24 cases of surgery wound infection (a hospital frequency of 9%. The average age was 41.41 years (y.o) old with extremes of 7 y.o and 102 y.o. The sex ratio was 0.9 in favor of women. The commonly studied pathologies were digestive surgery in 52.8%, gynecological surgery in 24.5%, etc… Patients were seen in regular outpatient surgery visits in 75.8% and surgical emergencies in 24.2%. Of the patients urgently admitted, 26.5% presented an ISO; for those received in ordinary consultation it was 3.48%. Fifteen (15) cases were classified ASA III and two (2) ASA II. Based on the Altemeier classification, surgery was clean in 66.8% of our patients, contaminated clean in 12.4%, contaminated in 12.1%, and dirty in 8.7% (including half resulting in surgery wound infection). In total, 79% of patients whose surgeries lasted more than two (2) hours presented a surgery wound infection. Postoperative infection of patients was superficial in 58.3% and deep in 33.3%. In 8.3% of cases, it was a space infection. At the cytobacteriological examination of the pus from the operative site, Escherichia coli (E. coli) was the most common germ with 58.3%. E. coli was sensitive to amoxicillin-clavulanic acid in 57.14%. Surgically, a re-intervention was performed in 20.8% of cases, a secondary suture in 12.5%, and a single dressing in 66.7%. The average postoperative stay was 6.5 days with extremes of 2 days and 69 days. In 3 months postoperatively we recorded 4 cases of death., Conclusion: The surgery wound infection constitutes a major complication in a surgical environment starting with surgical act itself.Particular emphasis should be placed on prevention, which will reduce the risks of ISO occurrence., (Le comité de rédaction se réserve le droit de renvoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de conserver un exemplaire du manuscrit, des figures et des tableaux.)

Aim: Our aim was to evaluate the diagnosis and therapeutic aspects of the amoebic liver abscesses in the surgery «A» department of the University hospital Point "G"., Patients and Methods: Were included in this study, patients admitted to the surgery «A» department for amoebic liver abscess confirmed by a positive amoebic serology and the chocolate appearance of bacteria-free pus. Bacterial liver abscesses were not included into this study., Results: Over a 10-year period, 52 cases of patients diagnosed with amoebic liver abscess were collected in the department. There were 41 men and 11 women, with a sex ratio of 3.7. The mean age was 37.8 years old with extremes of 15 and 66 years. The most represented professions were farmers (36.5%) followed by salesmen (26.7%) and students (11.5%). The average outpatient visit delay time was 18.5 days with the extremes of 5 and 34 days. The most frequent clinical signs were pain in the right hypochondrium (86.5%), fever (78.8%) and hepatomegaly (61.5%). Abdominal ultrasound showed a single located abscess in 44 patients (84.6%) and these abscesses were localized in the right hepatic lobe in 34 patients(65.4%). The average volume of the abscess was 366.5 cm 3 with the extremes of 36 cm 3 and 1580 cm 3 . Amoebic serology was positive in 38 patients (80.9%). Cytobacteriological analysis of pus in 37 patients (71%) was negative. Patients underwent an ultrasound assisted needle aspiration of pus in 65.4% he. Laparotomy and a laparoscopic approach were performed in 7.7% and in 5.8%, respectively. The clinical course was uneventfulin 94.2%. The mean hospital stay duration was 16.5 days with the extremes of 4 and 29 days. No death was recorded during hospitalization., Conclusion: Amoebic liver abscess is an uncommon pathology in a surgical setting. Abdominal ultrasound andechography guided liver puncture allowed the diagnosis. Laparoscopic approach minimizes the burden of the laparotomy., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Introduction: Necrotizing cellulitis of dental origin is a serious disease and requires prompt and effective management to avoid adverse outcomes. The purpose of this work is to describe the diagnostic and therapeutic difficulties encountered in this condition., Methods: This was a prospective study in the thoracic surgery department of Mali Hospital from January 2011 to February 2015. We collected consecutively 19 cases of complicating cervico-facial cellulitis of dental origin. The anatomical and clinical aspects, therapeutic modalities and difficulties are described., Results: Dental pain and fever were the predominant symptoms followed by cervical edema. Chest CT-scan was the basis for the diagnosis in all cases. Cervicotomy with debridement was the most performed surgical procedure. Pleural drainage was performed in 6 cases. Three patients (15.8%) died., Conclusion: Necrotizing cellulitis of dental origin is a serious disease with high morbidity and mortality. The key radiological examination is the thoracic CT-scan. Early medico-surgical management by emergency care, tailored antibiotic therapy, removal of necrotizing tissues and drainage of collections are required to deliver a good outcome., (Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Esophageal foreign bodies are a frequent reason for consultation in the Pediatric Emergency Department. However, they can occur at all ages. This study aims to highlight the clinical, paraclinical and therapeutic features of esophageal foreign bodies management at the Hospital in Mali. We conducted a prospective study of all cases of ingestion of foreign bodies between January 2011 and December 2014. A total of 36 patients underwent endoscopic or surgical treatment. The average age was 6 years (with a range from 14 months to 62 years). They mainly affected male patients with a sex ratio of 1.75. Foreign bodies were blocked in the cricopharyngeal shrinkage in 69.45% of cases, 22.22% of whom had subsequent aortic shrinkage. The average time of foreign body removal was 7.30 hours. Rigid fibroscopy allowed the removal of the foreign body in 88.89% of cases. Thoracotomy allowed the removal of the foreign body in 5.55%. Esophageal foreign bodies can occur at all ages but they are more frequent among children. Endoscopic removal is the gold standard treatment but surgical removal of a blocked esophageal foreign body, although rare, is the last resort, due to the nature of the foreign body and to the occurrence of complications. The best way to reduce accidents is prevention.

The aim of this study was to evaluate the surgical treatment of goiter in the «A» surgical department of the Point G University Hospital in Bamako., Patients and Methods: This was a retrospective and descriptive study in the «A» surgical department of the Point G University Hospital from January 2007 to August 2014. Included in the study were all the patients operated for goiter. The patients who underwent surgery for other thyroid diseases were not selected. Postoperatively patients were followed for one year. The sociodemographic, clinical, para-clinical, therapeutic aspects and the postoperative course were the study parameters. Data analysis was performed on SPSS 21. The Chi square test was used for statistical analysis. A p-value inferior to 0.05 was considered statistically significant., Results: A total of 378 patients' records were collected. Thyroidectomy represented 6.2% (378 cases) over 6027 operations. The mean age was 41.29 years with a standard deviation of 13.58. Extremes were 3 and 85 years. The sex ratio was 7.22 in favor of women. The frequent reason for consultation was due to antero-cervical tumor with 97.07% of cases (n = 367). We identified 118 cases (31.22%) of goiter in cooled hyperthyroidism patients, 211 cases (55.82%) of euthyroid goiter, 7 cases (1.85%) of the thyroid neoplasia and one case (0.3%) of hypothyroidism goiter. Pathological histology helped to highlight a micro-vesicular macro adenoma in 16.1% of cases (61 patients); adenocarcinoma in 0.7% of cases (3 patients) and papillary carcinoma in 1.1% of patients (4 patients). The patients classified as ASA I and ASA II represented the majority with respectively 248 cases (65.60%) and 120 cases (31.74%). The most performed surgical techniques were subtotal thyroidectomy (n=181; 49.7%), the isthmo-lobectomy (126; 33.3%), total thyroidectomy (n=11; 2.9%) and sternotomy in one case of endothoracic goiter. Intraoperative complications were marked by hemorrhage in 12.7% of cases (45 patients). The postoperative one month follow up was uneventful in 91.79% (n = 347) and transient recurrent nerve injury was found in 2% of cases (1 patient). In one year follow up the postoperative outcome was good in 94.17% (n = 356) of patients. The mean hospital stay was 4.18 days. Six deaths were recorded (1.7%)., Conclusion: Goiter surgery is relatively common in the surgery 'A' department of the Point G University hospital. Good patient preparation and a better postoperative monitoring could help to minimize postoperative complications., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: To analyze pregnancy outcomes after laparoscopic sleeve gastrectomy (LSG) according to body mass index (BMI) at conception and the interval between LSG and pregnancy., Methods: In a retrospective study, data were obtained for all women who became pregnant after LSG at a center in France between December 2001 and December 2011. Frequencies of perinatal events according to BMI at conception and the interval between LSG and pregnancy were compared., Results: A total of 63 pregnancies occurring in 54 patients were included, among which 52 (83%) occurred after the first postoperative year and 26 (41%) in women who remained obese. Compared with women who were no longer obese at conception, women who were still obese delivered neonates of significantly lower gestational age at birth (P=0.02) and birth weight (P=0.001). Odds of preterm delivery were also increased (odds ratio 4.37, 95% confidence interval 1.17-16.27; P=0.03). Maternal and neonatal outcomes according to the interval between LSG and pregnancy did not differ significantly., Conclusion: Women who remain obese following LSG are at increased risk of adverse outcomes, including low gestational age at birth, low birth weight, and preterm delivery, and should be regarded as a risk group., (Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)

Aim: to evaluate the contribution of laparoscopic surgery in the management of chronic abdominal pains of unspecified etiology., Methods: A retrospective descriptive study was conducted over a period of 49 months (March 2008 to March 2012), in the surgery A service of the Point G university hospital., Results: 52 patients suffering from chronic abdominal pain for 3 months have been listed. There were 36 women and 16 men, with a sex-ratio of 2.25. The pathologies found in laparoscopy were: 16 cases of adherences, 16 cases of gynaecological diseases, 6 cases of chronic appendicitis, 5 cases of chronic cholecystitis, 6 cases of abdominal tumors and 3 cases of intrauterine contraceptives in abdomen. Conversion to laparotomy was not made and mortality was null. No lesion was found in 11.54% of cases. The mean duration of hospitalization was 2 days. The duration of follow-up of the patients was 18 months with a minimum of 6 months and a maximum of 24 months. No painful symptomatology was found in 6 months in 88.46% of the cases. Persistent stomach pains were found in 3% of the cases. 8.54% of the patients had an improvement of symptomatology., Conclusion: Chronic abdominal pains put a diagnosis problem in surgery. Laparoscopy is a reference technique to diagnose this pain and to discuss them., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the introduction of anti-reflux system by diaphragmatic flap., Patients and Methods: This was a prospective study involved 21 patients (14 women and 7 men) operated for idiopathic megaesophagus during a period of 3 years. All the patients were operated by thoracotomy procedure. An anti-reflux system was performed using a diaphragmatic flap over the entire length of the myotomy., Results: The mean age was 32 years (range 16 and 68 years). After the surgery we have seen a complete disappearance of dysphagia in 21 patients (100 %) (p <0.001) and a significant weight regain. Short term outcomes were marked by the occurrence of clinical gastroesophageal reflux disease in 1 patient (4.76%) who has received the anti-reflux system (p> 0.05)., Conclusion: Oeso-cardio-myotomy of Heller by transthoracic procedure associated with the establishment of an anti reflux system by diaphragmatic flap has goods results., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: To evaluate the short-term results of the treatment of malignant gastric tumors., Patients and Methods: A 3-year retrospective study from january 2007 to december 2010 was conducted in the Surgery "A" department of the Point G Teaching Hospital. The clinical records of 84 patients with gastric cancers were collected. Included in this study were patients who underwent surgery for malignant gastric tumors confirmed by histology. Patients who did not undergo surgery and those who presented tumors of the cardia were not included in this study., Results: The treatment consisted of a subtotal gastrectomy with ganglionic curettage taking out the first and the second relays in 33 patients (39.28%), total gastrostomy in 3 patients (3.57%), and the remaining 48 patients (57.14%) underwent gastro-entero anastomosis. Morbidity was 10.7%, represented by 7 cases of parietal suppuration and 2 cases of evisceration. Mortality rate was 11.11%, due to poor general condition of the patients. The global 1-year survival rate was 36.9%. The one and two-year survival rates after subtotal gastrostomy were 93.9% and 75.75%, respectively. No survival case was noticed one year after total gastrectomy and gastric enteric anastomosis., Conclusion: Partial gastrectomy with ganglionic curettage when possible associated with an early diagnosis could allow a sharp improvement of the gastric tumors' survival rate., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Objective: To study the therapeutic aspects and prognosis of volvulus of the sigmoid colon in surgical departments., Patients and Methods: Our study was retrospective from January 2000 to December 2009 (10 years). All patients who underwent sigmoid volvulus in the Point G teaching hospital surgical departments were taken into account., Results: We recorded 96 patients operated for volvulus of sigmoid over 882 cases of bowel obstruction, a rate of 10.9%. The average age was 47.2 years ± 18.9. In per-operative, there was a necrosis of the colon rate of 16.7% (14 cases). Performed surgical treatment modalities were: sigmoidectomy with primary anastomosis in 29.2% of cases (28), sigmoidectomy followed by colostomy and secondary anastomosis in 60.4% of patients (58) and 10.4% rare of simple devolvulation. The immediate postoperative period were marked by a morbidity rate of 7.3% (7 cases) and a mortality rate of 7.3% (7 cases)., Conclusion: In spite of various therapeutic modalities of volvulus of the sigmoid colon, the rates of postoperative morbidity and mortality are rising in the general surgery of the Point G teaching Hospital., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Goal: To assess the surgical therapy in goiter with hyperthyroidism in a surgical unit of CHU du Point-G., Patients and Methods: A retrospective study was conducted, concerning 131 patients having undergone a thyroidectomy for goiter with hyperthyroidism from January 1st 1998 to December 31st 2007., Results: The files of 131 patients were analysed. The average age of patients was 39.74 years, with 114 women and 17 men. The goiter in Basedow disease was the first indication for surgery in hyperthyroidism (48 cases; 36.6%) followed by toxic adenoma (39; 29.8% of the cases) and toxic multinodular goiter (38; 29% of cases). Ninety patients had a subtotal thyroidectomy (68.7% of cases). One total thyroidectomy (0.8%), 39 isthmolobectomies (29.7%) and one isthmectomy (0.8%) were carried out. Anatomohistology showed 67.1% of colloid benign tumours, and 8 cases of cancers (6.2% of the cases). Early postoperative follow ups were due to hemorrhage (2 cases; 1.5%) and 3 cases of dysphonia (2.5%). One patient died (0.8%). After six months, 3 cases of wound cheloide (2.5%), one case of dysphonia, and one case of hypothyroidism were noted. For 86 patients (71.1%) the postoperative follow up was simple., Conclusion: Surgery remains a treatment of choice for hyperthyroidism goiter. Other options are too expensive or not available., (Le comitée de rédaction se réserve le droit de revoyer aux auteurs avant toute soumission à l'avis des lecteurs les manuscrits qui ne seraient pas conformes à ces modalités de présentation. En outre il leur conseille de sonserver un examplaire du manuscrit, des figures et des tableaux.)

Aims: To determine the most frequent causes of the digestive perforations and to evaluate the surgical procedures, the morbidity and mortality., Patients and Methods: It was about a retrospective descriptive study, over 5 year's period in a visceral service of CHU du Point G, Bamako. Were included in the study all the patients operated for digestive perforation and hospitalized in the service of surgery "A". Were not included in the study patient operated not presenting a digestive perforation. Per operational etiologies of the perforations and their frequency were determined, as well as the morbidity and morbidity and mortality., Results: Files of 202 patients were collected. The average age of the patients was 28.3 ± 15.5 years with extremes of 6 and 71 years. The frequency of digestive perforations was higher in the age from 11 to 20 years (29.7%). The average time of consultation was of 7± 6 days. Abdominal pains, nauseas and vomiting, matter and gas stop (48.5%) were the most current functional signs. A "wood belly" abdomen was found in 72,3% of the cases. The radiography of abdomen without preparation found a diffuse greyness (64.7%), a pneumoperitoine (30.7%). A double antibiotic therapy was made in all the cases. A median laparotomy was practiced in 98,5%, and laparoscopy in 3 cases (1.5%). A single perforation was found among 172 patients (85,1%). Morbidity, all confused causes, was made of 30 cases of parietal suppurations (14.8%). Total mortality was 74%. According to aetiologies it was 10.3% in the typhic perforations, 4.6% in the appendicular perforations and 4.9% in the perforations of gastroduodenal ulcers., Conclusion: The most frequent aetiologies of digestive perforation in our context were the typhoid fever, acute appendicitis and the gastroduodenal ulcer. The résection - joining and peritoneal toilet were the most practised procedure. The main factor of bad outcome remains the diagnostic delay burdening morbidity and mortality.

Objective: To evaluate the short term outcome of patients who underwent pleuro-pulmonary decortication., Method: This is a retrospective study of 174 patients treated for thoracic empyema in Point G Hospital, Bamako/Mali, between 2004 and 2007. Perioperative data of 51 patients who underwent pleuro-pulmonary decortication had been recorded., Results: Of the 174 patients treated, 51 (29.3%) underwent pleuro-pulmonary decortication. 84.5% were male and 70.6% were less than 45 years old. A recent history of tuberculosis was found in 59%. Among the four patients selected for a thoracoscopic procedure, only two were treated successfully. A conventional postero-lateral thoracotomy was used in the remaining 49 patients. The lung expansion, estimated intraoperatively, was complete in 43 cases and incomplete in eight cases. Among these eight patients with incomplete lung expansion, four developed a secondary empyema and required a thoracoplasty. The postoperative mortality was 6% (three patients)., Conclusion: In our hospital, one third of patients with thoracic empyema required a pleuro-pulmonary decortication. Incomplete lung expansion is a potential risk factor of postoperative infection necessitating re-operation or more extensive surgical procedures., (Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.)