Résection endoscopique des polypes colorectaux pédiculés en utilisant un lasso largable au fil catgut chromé : une alternative a la polypectomie conventionnelle? A propos d’une série de cas

L'intérêt de l'endoscopie dans la résection des polypes colorectaux a été rapporté dans plusieurs études. Les techniques de résection endoscopique sont multiples et maîtrisées dans les pays occidentaux. La technique de mucosectomie endoscopique et celle de la pose d'une anse largable en nylon (endoloop) ont élargi le champ des lésions résécables par endoscopie. Toutefois, malgré cette évolution, la vulgarisation de la polypectomie n'est pas effective. En Afrique subsaharienne, la prise en charge de ces polypes de grande taille nécessite souvent une intervention chirurgicale à ciel ouvert ou une évacuation sanitaire onéreuse dans un pays en Occident. Nous rapportons une nouvelle approche de polypectomie endoscopique des polypes pédiculés colorectaux, en utilisant un lasso largable au fil catgut chromé 2/0. Les polypes pédiculés étaient situés soit au niveau du sigmoïde soit au rectum. Après avoir passé le lasso autour du pédicule, le n'ud du lasso est serré autour de celui-ci pour strangulation. En moyenne 6 jours après la procédure, le polype est récupéré dans les selles. Une colonoscopie de contrôle est nécessaire pour confirmer la résection du polype. Cette technique peu coûteuse et accessible, devrait être vulgarisée dans les pays en voie de développement avec des plateaux techniques pauvres. Elle a ses limites et ses inconvénients qui doivent être connus de l'opérateur.Key words: Polypes coliques, catgut, polypectomie endoscopique, coloscopie, endoloop, Cameroun, Afrique subsaharienn

EPIDEMIOLOGICAL ASPECT OF POSTOPERATIVE GASTROINTESTINAL NUTRITIONAL DEFICIENCY IN NGAOUNDERE HOSPITALS, ADAMAWA REGION, CAMEROON

Background and objective: Undernutrition is defined as an insufficient intake of nutritional foods. The aim of this study was to evaluate the epidemiological aspect of postoperative gastrointestinal nutritional deficiency in Ngaoundere Hospitals. Methods: It was a prospective, cross-sectional study with an analytical focus, over a 5-month period from July to November 2022. Undernutrition was defined by the presence of at least one phenotypic criteria plus one etiological criteria. Logistic regression for multivariate analyses, and the Chi-square test for univariate analyses, were used to identify the determinants of undernutrition. A difference was considered significant if p<0.05. Results: A total of 134 patients were included in the current study. Males were the most represented, with rates of 82.09%. The average age of patients was 36±17.78. Undernutrition at discharge was observed in 110 patients (82.09%). Endogenous risk factors associated with the occurrence of undernutrition were: Muslim religion, persistent symptoms, emergency surgery modality, nutritional grades, postoperative nausea, and diarrhea (p<0.0001); the protective one was minor surgery (p<0.0001). Exogenous risk factors for undernutrition included failure to meet carbohydrate, protein, and calorie targets on day-3 and at discharge (p<0.0001). Finally, in multivariate analysis, persistent symptoms (p=0.02), minor surgery (p=0.04), presence of diarrhea (p=0.01), and failure to meet caloric targets were independently associated with undernutrition at discharge. Conclusion: The incidence of post-digestive surgery undernutrition is relatively high in the 2 hospitals in Adamawa, Cameroon. It, therefore, requires early detection and management.                         Peer Review History: Received: 7 September 2023; Revised: 2 October; Accepted: 9 November, Available online: 15 November 2023 Academic Editor: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, [email protected] Received file:                             Reviewer's Comments: Average Peer review marks at initial stage: 6.0/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected] Dr. Owanaro Peter, Nigeria,  Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria. [email protected]

EVALUATION OF CALORIC INTAKE, KNOWLEDGE, AND PRACTICES ON POSTOPERATIVE REFEEDING IN DIGESTIVE SURGERY IN NGAOUNDERE HOSPITALS, ADAMAWA REGION, CAMEROON

Background and objective: Insufficient caloric intake among postoperative digestive surgery patients, linked to a lack of knowledge and practices regarding their re-feeding, is a frequent health problem in developing countries. The aim of this study was to assess the caloric intake of postoperative digestive surgery patients, as well as the knowledge and practices related to their refeeding in two hospitals in the city of Ngaoundere. Methods: This was an observational, analytical, cross-sectional, prospective cohort study over a 5 months period from June to November 2022, focusing on the patients, the diets of post-digestive surgery patients, their nurses, and the operating theatre nursing staff. Caloric targets were defined as those with mean intakes above 15 kcal/kg/day at day 3 and 25 kcal/kg/day at discharge. Results: A total of 134 patients, 240 caretakers, 20 nursing staff, and 614 dieters (meals) were included in the study. Males were more represented, with rates of 82.1%, 56.7%, and 75% for patients, nurses, and staff respectively. 25.4% of day-3 caloric targets and 24.6% of discharge caloric targets were met. The Kruskal-Wallis test was used to investigate daily variations in means for each macronutrient, the difference being significant at p<0.05. Lack of information and practice on the composition of a porridge, food frequency score, feeding chronology, and lack of nursing practice on the part of operating room nursing staff, were the main reasons observed. Conclusion: The dietary balance in postoperative digestive surgery patients and the practices of re-feeding are deficient in the 2 hospitals in the town of Ngaoundere, suggesting an in-depth study of the dietary consequences they may have, such as undernutrition.                          Peer Review History: Received: 15 June 2023; Revised: 13 July; Accepted: 29 August, Available online: 15 September 2023 Academic Editor: Dr. Gehan Fawzy Abdel Raoof Kandeel, Pharmacognosy Department, National Research Centre, Dokki, 12622,  Giza, Egypt, [email protected]  Received file:                             Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, [email protected] Dr. Muhammad Zahid Iqbal, AIMST University, Malaysia, [email protected]