Totally laparoscopic esophago-gastrectomy

SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Incidence of Post-Operative Complications and Factors Influencing Their Occurrence in Patients with Sickle Cell Disease in a Low-Income Country: A Case Study of Cameroon

This study aimed to analyse post-operative complications and possible factors influencing their occurrence in the management of patients with sickle cell disease in a low-income country. We prospectively collected data regarding the management of patients with sickle cell disease requiring anesthesia for surgery in 11 Cameroonian hospitals from 1 May 2019 to 30 April 2021. The data were analysed using descriptive statistics and a binary logistic regression was used to determine the dependence between the variables. A total of 124 patients with sickle cell disease were enrolled; 64 were male and 60 female, giving a sex ratio of 0.93. The rate of post-operative complications was 23.4% (29/124) and the death rate was 3.2% (4/124). The female subjects had more complications than the male subjects p < 0.05. The number of vaso-occlusive crises experienced per year showed a significant impact on the occurrence of post-operative complications p < 0.05. Laparoscopic surgery had fewer post-operative complications 5/46 (10.9%) than laparotomy 14/43 (32.5%). The surgical technique for the abdominal procedures had a significant impact on the occurrence of post-operative complications p < 0.05. The type of surgery (p = 0.198) and the anaesthesia technique (p = 0.225) did not show a significant impact on the occurrence of post-operative complications. Particular attention should be paid to female patients with sickle cell disease as they are more likely to experience postoperative complications, as well as to the frequency of vaso-occlusive crises, which are also predictive of post-operative complications. Opting for laparoscopic surgery whenever possible would help to reduce post-operative complications.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Les plaies pénétrantes de l’abdomen avec éviscération : aspects cliniques, thérapeutiques et pronostiques sur 2 centers à Yaoundé

English Title: Penetrating wounds of the abdomen with evisceration: clinical, therapeutic and prognostic aspects on 2 centers in Yaounde Introduction: Les plaies pénétrantes de l’abdomen (PPA) avec éviscération représentent une majeure partie des urgences chirurgicales viscérales, avec des chiffres préoccupants. Elles nécessitent une bonne sélection des malades en vue de réduire le taux de laparotomie blanche, sans augmenter la morbi-mortalité.Méthodologie: Nous avons mené une étude rétrospective, descriptive et multicentrique. Elle s’est déroulée dans les services de chirurgie du Centre des Urgences de Yaoundé(CURY), et le bloc des urgences de l’hôpital Central de Yaoundé (HCY) sur une période de 2 ans allant du 1 er janvier 2016 au 31decembre 2017.Résultats: Au total 65 patients porteurs de PPA avec éviscération ont été recensés. L’adulte jeune de sexe masculin était le plus touché, la profession de commerçants plus concernée (32,31%). Les agressions (66%) entrainaient un grand nombre de plaies à domicile (40%) par arme blanche (71%). La région ombilicale était la plus atteinte (20%) avec le grêle comme étant le viscère le plus extériorisé (36%). La stabilité hémodynamique (48%), et l’absence de signes d’irritation péritonéale (37%) justifiaient un traitement non opératoire « expectative armée » (36%) en lieu et place d’une laparotomie exploratrice (64%). Sur le plan pronostic, les suites opératoires étaientsimples (92%) réduisant ainsi la durée d’hospitalisation entre 5-10jours (65%).Conclusion: Les PPA avec éviscération sont en hausse chez l’adulte jeune. Chez les patients hémodynamiquement stables et sans signes d’irritation péritonéale, une exploration et réparation pariétale sous anesthésie locale suivi d’une expectative armée peut être considérée, mais dans plus de la moitié des cas une laparotomie exploratrice est indiquée. Mots clés: Plaies pénétrantes – éviscération - Laparotomi

Penetrating cardiac injuries in Belgium: 20 years of experience in university hospitals in Brussels.

Cardiac wounds remain as highly lethal lesions in which their prognosis depends on the emergency management.info:eu-repo/semantics/publishe

Late diagnosis of intestinal malrotation treated with gastrojejunal bypass: A case report

We report the case of a male African patient who presented at day 8 of life with recurrent episodes of proximal small intestine occlusion, which was treated conservatively, because of misdiagnosis. Physical and cognitive development was normal throughout with, however, some episodes of stagnation. At the age of 15 years the recurrence of symptoms, not responding to the current conservative treatment, resulted in severe weight loss with BMI at 11 kg/m2. The oesogastroduodenal barium study disclosed an extrinsic duodenal compression compatible with a congenital duodenal band. Because of the major concerns related to the patient and to the medical environment, jejunostomy for feeding was first performed to improve his weight. A year later the intestinal malrotation was cured by gastrojejunal bypass. The postoperative clinical course was favorable. The patient resumed a normal life and schooling. His BMI is currently 21.5 kg/m2.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Prospective, randomized clinical trial of laparoscopic totally extraperitoneal inguinal hernia repair using conventional versus custom-made (mosquito) mesh performed in Cameroon: a short-term outcomes.

Adverse economic conditions often prevent the widespread implementation of modern surgical techniques in third world countries such as in Sub-Sahara Africa.info:eu-repo/semantics/publishe

Outcome of permanent vascular access for haemodialysis in patients with end-stage renal disease in Cameroon: Results from the pilot experience of the Douala general hospital

Background: Chronic Kidney disease is a major health problem in the world. Native arteriovenous Fistula (AVF) is well established as the best vascular access for haemodialysis. Little is known about the outcome of AVF in sub-Saharan Africa. We aim to analyze the outcome of patients undergoing AVF creation during the pilot program established at the Douala general hospital (DGH). Method: This was hospital-based, longitudinal study with a retrospective phase (April 2010-January 2014) and a prospective phase (January 2014-April 2014). All consecutive patients operated for AVF creation were included in this study. Socio-demographics data, functionality, and complications were analyzed. Results: Eighty-one patients including 52 men were enrolled in this study (49 prospectively and 32 retrospectively). The mean age was 52, 3 years (range 18-81 years). Hypertension (66, 7%), diabetes (17, 3%), and HIV (8, 6%) were the most observed co-morbidities. About 96.3% of AVF were native and 3.7% were prosthetic graft. Radiocephalic AVF was performed at a rate of 77.8%. The primary function rate was 97.7% and the mean follow-up period 43.4 weeks. The overall rate of complications was 44.4% of whom 30.5% were early, 30.5% secondary, and 39% lasted. The treatment of these complications was conservative in 48.7% of cases. Conclusions: The results of the pilot program of AVF creation at the DGH are encouraging. However, the sustainability of this project requires human capacity building.SCOPUS: ar.jinfo:eu-repo/semantics/publishe