Les Resultats De L\'orchidopexie Indiquee Dans Le Traitement Chirurgical De La Cryptorchidie Chez L\'enfant : A Propos De 120 Cas Colligés Dans Le Service De Chirurgie Pédiatrique Du Centre Hospitalier Universitaire de Treichville, Cote d\'Ivoire.

Les auteurs rapportent une étude rétrospective à propos des dossiers de 120 enfants âgés de sexe masculin de 0 à 15 ans, opérés en 15 ans pour cryptorchidie. La cryptorchidie était unilatérale droite dans 59 cas (49 %), gauche dans 43 cas (36 %) et bilatérale dans 18 cas (15 %). Les testicules étaient palpables 126 fois et non palpables dans 12 cas. Sur ces 12 patients présentant une localisation abdominale, 4 patients (33 %) avaient une cryptorchidie bilatérale et 8 (67 %), une localisation unilatérale. La technique opératoire utilisée était l\'abaissement testiculaire avec fixation du testicule entre la peau et le dartos. Cinquante trois patients (44 %) étaient opérés entre 2 et 3 ans d\'âge. L\'abaissement en un temps a été effectué fait chez 117 patients (97,5 %) et en deux temps chez 3 patients (2,5 %). Le testicule était situé à l\'orifice inguinal externe dans 51 cas (42,5 %), dans le canal inguinal dans 42 cas (35 %), à l\'orifice inguinal interne dans 15 cas (12,5 %) et abdominal dans 12 cas (10 %). Dix patients (8,3 %) présentaient une absence de fusion épididymo-testiculaire, 9 patients (7,5 %) une atrophie testiculaire. Quatre vingt seize patients (80 %) avaient un processus péritonéo-vaginal perméable, 3 patients (2,5 %), un cordon spermatique court, 1 patient (0,85 %) avec testicule évanescent, 1 patient (0,85 %) avec testicule dysplasique. Sur 138 testicules abaissés 14, sont remontés (10 %). L\'abaissement testiculaire avec orchidopexie entre le dartos et la peau donne des résultats satisfaisants, aussi bien à court, moyen et long terme. Les auteurs recommandent l\'orchidopexie à environ 2 ans d\'âge.This is a retrospective study of 120 children treated for cryptorchidism during a 15 year period. Cryptorchidism was located on the right side in 59 patients (49%), left in 43 (36%) and bilateral in18 (15%). The testes were palpable in 126 patients and non- palpable in 12. Amongst the 12 patients with abdominal cryptorchidism, 4 had both testes affected, and in 8, only one was affected. The surgical technique used was lowering and fixing the testes between the scrotal and dartos fascias. Fifty three patients (44%), were operated within the 2 to 3 years age group. One stage orchidopexy was done in 117 patients (97.5%), and two stage in 3 patients (2.5%). The testes were located at the external inguinal ring in 51 patients (42.5%), inside the inguinal canal in 42 (35%), at the internal inguinal ring in 15 (12.5%), and abdominal in 12 (10%). Ten patients (8.3 %) had no epididymo-testicular adhesion, and 9 (7.5 %) had testicular atrophy. Ninety six (80 %) patients had patent processus vaginalis, 3 (2.5 %) a short spermatic cord, 1 (0.85 %) evanescent testes, and in 1 (0.85 %) the testes were dysplasic. Amongst the 138 testes which underwent orchidopexy, 14 (10%) ascended back. Lowering of the testes with orchidopexy between the scrotal and dartos fascias gives good results at short, mid, and long term. The authors thus recommend orchidopexy in children at two years of age. Keywords: Orchidopexy- Children - Cryptorchidism.Clinics in Mother and Child Health Vol. 4 (2) 2007 pp. 711-71

Outcomes of conservative treatment of giant omphaloceles with dissodic 2% aqueous eosin: 15 years′ experience

Background: The surgical management of giant omphalocele is a surgical challenge with high mortality and morbidity in our country due to the absence of neonatal resuscitation. This study evaluates conservative management of giant omphalocele with dissodic 2% aqueous eosin. Materials and Methods: In the period from January 1997 to December 2012, giant omphaloceles were treated with dissodic 2% aqueous eosin. The procedure consisted of twice a day application of dissodic 2% aqueous eosin (sterile solution for topical application) on the omphalocele sac. The procedure was taught to the mother to continue at home with an outpatient follow-up to assess epithelialization. We studied the duration of the hospital stay, the learning curve of the procedure by the mother, the complications, the duration and the percentage of complete epithelialization and the mortality. Results: A total of 173 giant omphaloceles had a conservative treatment with dissodic 2% aqueous eosin. The average hospital stay was 21 ± 6 days. The learning curve by the mother of the procedure was 10 ± 3 days. Complications of treatment were intestinal functional occlusion 22% and omphalocele sac infection 18%. The complete epithelialization of the omphaloceles sac after application of dissodic 2% aqueous eosin was 68.5%. Mortality was observed in 25.5%. Conclusion: Conservative treatment of giant omphaloceles by dissodic 2% aqueous eosin is a simple, efficient and a good alternative to surgery. The mother can easily learn its procedure which reduces the duration of hospital stay