Zakari Saye - Academia.edu (original) (raw)
Papers by Zakari Saye
Surgical Science, 2021
Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-... more Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.
Journal of Cancer Therapy, 2022
Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. Th... more Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracyclinebased chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history; nulliparous; followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration; a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy; the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.
Surgical Science, 2022
Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstructio... more Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion: NIS is an emergency, the diagnosis and the management must be fast and precise.
Surgical Science, 2022
The appendicular peritonitis is complications of acute appendicitis which are characterized by th... more The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1 st to December 31 st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which represented 4.36% of surgical interventions, 19.25% of urgent surgeries. The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years ± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound). The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage. The average length of hospital stay was 8.8 days with extremes of 1-44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.
Surgical Science, 2022
Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cau... more 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. Material and methods: This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020...
![Research paper thumbnail of [Prise en charge chirurgicale des goitres hyperthyroïdiens a Bamako]](https://attachments.academia-assets.com/104967372/thumbnails/1.jpg)
](Le Mali medical, 2012
GOAL To assess the surgical therapy in goiter with hyperthyroidism in a surgical unit of CHU du P... more 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%). O...
Surgical Science
Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. G... more Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. Gastric cancer is a common cancer occupying the 5th rank of cancers in the world, or 5.7% of all cancers. Purpose: To study epidemiological, diagnostic, therapeutic, and prognostic aspects of stomach cancer. Methodology: This was a retrospective and prospective study, which was carried out in the General Surgery Department at the teaching hospital Gabriel Touré between January 1, 1999, and December 31, 2020, and all cases of stomach cancer were confirmed by histological examination. Result: We recorded 857 cases of stomach cancer or 40.1% of digestive cancers. The sex ratio was 1.6. The average age was 55 years ± 13 years. The main clinical signs were epigastralgia (98.6%), vomiting (93.34%), weight loss (96.03%), and anorexia (46.1%). It was adenocarcinoma (97.55%), and antropyloric location (78.64%). Patients were Stage IV (72.817%) cases. Among the 857 patients, 722 were operated on, accounting for 84.25% of the cases. Surgery was palliative in 60.66% and curative in 25.62%. Gastrectomy of 4/5 plus D2 type curage was the most performed in curative surgery. The median overall postoperative survival was 5 months. Conclusion: Stomach cancer is the most common digestive cancer in our department, the diagnosis is most often late, so palliative surgery occupies an important place.
Surgical Science, 2020
The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop a... more The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop around its mesenteric axis resulting in partial or complete obstruction of the colonic lumen. It is the most common intestinal volvulus and is an absolute medical and surgical emergency. Objectives: Determine the frequency of sigmoid colon volvulus, describe clinical and para-clinical signs, describe treatment, and determine morbidity and mortality. Methodology: This was a retrospective and prospective study performed in the General Surgery Department of Sikasso. This study concerned patients admitted and operated for sigmoid volvulus from January 1, 2014 to December 31, 2017. Retrospective Phase: We have created survey cards to study the following parameters: 1) The age and the sex; 2) The clinical signs and associated defects; 3) The radiological examinations, endoscopic; 4) The established treatment whether medical, or surgical; 5) The evolution and the postoperative consequences; 6) The admission period. Prospective Phase: At the admission each patient to benefit: a complete interrogation, a complete physical examination, additional examinations including radio of the abdomen without preparation, the rate of hemoglobin and hematocrit, grouping/rhesus. Support: Our data were collected from medical records and operating records of patients in the department. Results: We collected 54 cases of sigmoid volvulus (the annual frequency was 13.5 cases for year), which accounted for 58.1% of colonic occlusions 19.6% of intestinal occlusions and 5.9% of operative operations in emergency. The average age was 47.13 with extremes of 18 and 102 years, The sex ratio is 4.40% in favor of men. Abdominal pain, vomiting, stopping of materials and gases were present in 32 (59.3%) patients. Von Wahl's triad was present in 36 patients (66.7%), the rectal ampoule empty in 92.6%. On the X-ray of the abdomen without preparation, 70.37% of the image was recorded as a double leg. The sigmoid was necrotic in 37% of cases, and a sigmoid volvulus
Surgical Science, 2019
Introduction: Despite the use of less invasive and increasingly effective techniques in order to ... more Introduction: Despite the use of less invasive and increasingly effective techniques in order to reduce the morbi-mortality per and post-operative, the CPPO remain an important problem in surgery. Objectives: To determine the rate of per and post-operative complications, to describe the types of complications and to identify their risk factors. Methodology: This was a prospective study carried out from 04 April to 03 June 2016 in the surgical department of CHU-Gabriel TOURE. All patients aged 18 and over operated in the Surgical Department
Advances in Breast Cancer Research, 2022
The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. ... more The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, and the number of axillary lymph nodes metastasizing changes the stage. Since tuberculosis also produces lymph node enlargement, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. Additionally, fine needle aspiration cytology (FNAC) of such cases can be misleading if only one of the diseases is detected. We report two cases of infiltrating carcinoma of the nonspecific type of the breast in two women aged 35 and 55 where tuberculosis was found in the axillary lymph nodes in addition to metastases. As the present case led to the fortuitous discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexisting lesion in the minds of pathologists, especially in areas endemic to tuberculosis.
Surgical Science, 2022
Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accid... more Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases)...
Journal of Cancer Therapy, 2022
Introduction: Male breast cancer is rare; representing 1% of breast cancers and less than 1% of a... more Introduction: Male breast cancer is rare; representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23-82); a family history of cancer in 2; breast pain in 9; the average time to consultation of 8 years (6-24); gynecomastia found in 1; the tumor palpable in all 14 (size of 5 cm [3-10]); ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%; radical surgery in 13 cases; surgery + radiotherapy in 2; surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.
Surgical Science
Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolis... more Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.
Surgical Science, 2021
Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-... more Synchronous transverse and sigmoid colon volvulus are very rare. We report the case of a 23-year-old man who underwent emergency surgery for sigmoid colon volvulus. An intraoperative finding of transverse colon volvulus associated with sigmoid colon volvulus was made. Left and transverse colectomy was performed followed by colorectal anastomosis. The postoperative period was uneventful. Synchronous volvulus of the transverse and sigmoid colon is a surgical emergency. The clinical signs are not specific and the discovery is often intraoperative. It is necessary to know how to evoke the diagnosis in a case of sigmoid colon volvulus, to avoid inadequate management with dramatic consequences.
Journal of Cancer Therapy, 2022
Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. Th... more Primary breast lymphomas are rare. They are defined by the involvement of one or both breasts. This is the first site affected or mainly affected with the exception of ipsilateral axillary involvement. Due to the absence of specific clinical and radiological signs, the diagnosis is confirmed by histology. The most frequent entity remains diffuse large B-cell lymphomas. The place of surgery remains exclusive in establishing the initial diagnosis. Anthracyclinebased chemotherapy with or without Rituximab remains the gold standard in the therapeutic arsenal. We present the case of a 42-year-old woman with no surgical history; nulliparous; followed in nephrology for chronic renal failure, received as an outpatient for a nodule in the left breast in a context of dyspnea. This is a nodule discovered incidentally during a routine examination. Clinical examination of the left breast found nipple retraction without ulceration; a mass 7 cm in diameter located in the left upper outer quadrant. Breast ultrasound and mammography suggest a suspected lesion of malignancy. After a percutaneous micro biopsy; the histological study confirms the diagnosis of a large B-cell lymphoma of the left breast. A TAP CT scan is performed as part of the extension assessment. Chemotherapy based on R-CHOP with local radiotherapy is decided in CPR.
Surgical Science, 2022
Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstructio... more Introduction: Emergency medico-surgical ileosigmoid node is a rare cause of intestinal obstruction. Diagnosis and treatment must be prompt. Objective: To determine the frequency of NIS, to describe the diagnostic aspects, therapeutic aspects and to analyze the postoperative effects. Methodology: Retrospective and prospective study from January 2006 to December 2020 including all patients operated on for ileosigmoid node confirmed by the intraoperative diagnosis at the CHU Gabriel Touré. Results: From January 2006 to December 2020 (15 years), 30 cases of ileo-sigmoid node were recorded in the service. During this period NIS accounted for 0.19% of surgeries. Abdominal pain was present in (100%) of cases, vomiting was present in 80% and cessation of materials and gas (57%). All of our patients underwent ASP and CT (1 case). All of our patients were operated on, and exploration revealed intestinal necrosis in 97%. The surgical procedures performed were colostomy according to HARTMANN (63%), anastomosis resection (16%), devolvulation (10%). Restoration of continuity was achieved in (73%). The postoperative consequences were straightforward in (80%). Morbidity was 17% including infection of the lining. Mortality was 3% (1 case). Conclusion: NIS is an emergency, the diagnosis and the management must be fast and precise.
Surgical Science, 2022
The appendicular peritonitis is complications of acute appendicitis which are characterized by th... more The appendicular peritonitis is complications of acute appendicitis which are characterized by the diffusion of the infectious process to the peritoneal cavity thus carrying out a generalized or located purulent peritonitis. It can appear from the start or follow the stage of appendicular abscess. Our objectives were to determine the frequency, to describe the clinic and para clinic aspects, to identify the principal germs and their sensitivities to antibiotics and to describe the operative continuations. Our prospective and descriptive study focused on patients treated for appendicular peritonitis, from January 1 st to December 31 st 2016, in the General Surgery Department of the Hospital of Sikasso. During the period of our study, 31 cases of appendicular peritonitis were collected, which represented 4.36% of surgical interventions, 19.25% of urgent surgeries. The male sex accounted for 71.0% with a sex-ratio of 2.44 at the risk of males, the average age was of 20 years ± 12.99, the abdominal pain + vomiting was the reason for consultation in 54.8% of cases. The physical examination allowed in most cases to make the diagnosis. In doubtful cases some additional examinations have been requested (abdomen without preparation, abdominal ultrasound). The surgical treatment consisted of an appendectomy with peritoneal lavage followed by drainage. The average length of hospital stay was 8.8 days with extremes of 1-44 days. Hospital mortality was 9.7%. Delay in consultation and age were factors of morbidity and high mortality.
Surgical Science, 2022
Introduction: Sigmoid colon volvulus is a medico-surgical emergency which represents a common cau... more 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. Material and methods: This was a retrospective and prospective study that took place from January 2008 to December 2020 in the General Surgery Department of Gabriel Touré. The retrospective phase ran from January 2008 to December 2019 and the prospective phase from January 2020...
Le Mali medical, 2012
GOAL To assess the surgical therapy in goiter with hyperthyroidism in a surgical unit of CHU du P... more 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%). O...
Surgical Science
Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. G... more Introduction: Stomach cancer is a malignant tumor developed at the expense of the gastric wall. Gastric cancer is a common cancer occupying the 5th rank of cancers in the world, or 5.7% of all cancers. Purpose: To study epidemiological, diagnostic, therapeutic, and prognostic aspects of stomach cancer. Methodology: This was a retrospective and prospective study, which was carried out in the General Surgery Department at the teaching hospital Gabriel Touré between January 1, 1999, and December 31, 2020, and all cases of stomach cancer were confirmed by histological examination. Result: We recorded 857 cases of stomach cancer or 40.1% of digestive cancers. The sex ratio was 1.6. The average age was 55 years ± 13 years. The main clinical signs were epigastralgia (98.6%), vomiting (93.34%), weight loss (96.03%), and anorexia (46.1%). It was adenocarcinoma (97.55%), and antropyloric location (78.64%). Patients were Stage IV (72.817%) cases. Among the 857 patients, 722 were operated on, accounting for 84.25% of the cases. Surgery was palliative in 60.66% and curative in 25.62%. Gastrectomy of 4/5 plus D2 type curage was the most performed in curative surgery. The median overall postoperative survival was 5 months. Conclusion: Stomach cancer is the most common digestive cancer in our department, the diagnosis is most often late, so palliative surgery occupies an important place.
Surgical Science, 2020
The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop a... more The sigmoid volvulus is an acute strangulation of the colon by the twisting of the sigmoid loop around its mesenteric axis resulting in partial or complete obstruction of the colonic lumen. It is the most common intestinal volvulus and is an absolute medical and surgical emergency. Objectives: Determine the frequency of sigmoid colon volvulus, describe clinical and para-clinical signs, describe treatment, and determine morbidity and mortality. Methodology: This was a retrospective and prospective study performed in the General Surgery Department of Sikasso. This study concerned patients admitted and operated for sigmoid volvulus from January 1, 2014 to December 31, 2017. Retrospective Phase: We have created survey cards to study the following parameters: 1) The age and the sex; 2) The clinical signs and associated defects; 3) The radiological examinations, endoscopic; 4) The established treatment whether medical, or surgical; 5) The evolution and the postoperative consequences; 6) The admission period. Prospective Phase: At the admission each patient to benefit: a complete interrogation, a complete physical examination, additional examinations including radio of the abdomen without preparation, the rate of hemoglobin and hematocrit, grouping/rhesus. Support: Our data were collected from medical records and operating records of patients in the department. Results: We collected 54 cases of sigmoid volvulus (the annual frequency was 13.5 cases for year), which accounted for 58.1% of colonic occlusions 19.6% of intestinal occlusions and 5.9% of operative operations in emergency. The average age was 47.13 with extremes of 18 and 102 years, The sex ratio is 4.40% in favor of men. Abdominal pain, vomiting, stopping of materials and gases were present in 32 (59.3%) patients. Von Wahl's triad was present in 36 patients (66.7%), the rectal ampoule empty in 92.6%. On the X-ray of the abdomen without preparation, 70.37% of the image was recorded as a double leg. The sigmoid was necrotic in 37% of cases, and a sigmoid volvulus
Surgical Science, 2019
Introduction: Despite the use of less invasive and increasingly effective techniques in order to ... more Introduction: Despite the use of less invasive and increasingly effective techniques in order to reduce the morbi-mortality per and post-operative, the CPPO remain an important problem in surgery. Objectives: To determine the rate of per and post-operative complications, to describe the types of complications and to identify their risk factors. Methodology: This was a prospective study carried out from 04 April to 03 June 2016 in the surgical department of CHU-Gabriel TOURE. All patients aged 18 and over operated in the Surgical Department
Advances in Breast Cancer Research, 2022
The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. ... more The coexistence of tuberculosis with axillary lymph node metastases in breast carcinoma is rare. Axillary lymph node metastasis is the most important factor in the staging of breast carcinoma, and the number of axillary lymph nodes metastasizing changes the stage. Since tuberculosis also produces lymph node enlargement, this can mimic or complicate the staging of a malignant disease. Dual organ pathology can lead to interpretation difficulties and inappropriate treatment of tuberculosis as well as breast carcinoma. Additionally, fine needle aspiration cytology (FNAC) of such cases can be misleading if only one of the diseases is detected. We report two cases of infiltrating carcinoma of the nonspecific type of the breast in two women aged 35 and 55 where tuberculosis was found in the axillary lymph nodes in addition to metastases. As the present case led to the fortuitous discovery of tuberculosis with tumor metastasis, it reinforces the possibility of a coexisting lesion in the minds of pathologists, especially in areas endemic to tuberculosis.
Surgical Science, 2022
Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accid... more Traumatic diaphragmatic injury (TDI) is rare and is most often the result of a traffic road accident (TRA) or an assault. We initiated this study with the aims of determining the epidemiological, clinical and therapeutic aspects of TDI at Gabriel Toure University Hospital. This was a retrospective study from January 1999 to June 2021 that included all patients who presented a diaphragmatic injury consecutive to abdominal and/or thoracic trauma. In 22 years and 6 months, 46 cases of TDI were collected. They represented 0.17% of hospitalizations, 0.26% of surgical emergencies and 5.5% of thoraco-abdominal traumas. The average age was 31.69 years with a sex ratio of 3.2. Criminal stabbings accounted for 56.5% and TRA for 19.6%. Penetrating injuries accounted for 78.3% of cases. The parietal lesion was thoracic in 21 cases (45.7%), abdominal in 19 cases (41.3%) and thoraco-abdominal in 6 cases (13%). The chest X-ray, performed in 15 patients, showed an intrathoracic gas bubble (4 cases)...
Journal of Cancer Therapy, 2022
Introduction: Male breast cancer is rare; representing 1% of breast cancers and less than 1% of a... more Introduction: Male breast cancer is rare; representing 1% of breast cancers and less than 1% of all male neoplasia worldwide. We here analyzed the clinical, histological, therapeutic and prognostic characteristics of male breast cancer in Bamako, Mali. Patients and methods: A retrospective descriptive study was conducted on 14 male patients with breast cancer who visited two university hospitals in Bamako (Hospital Gabriel TOURE and Hospital du Point G) in Mali, from January 2005 to December 2018. Results: Male breast cancer represented 0.63% of all breast cancers and 0.23% of all male cancers. The following was observed: the mean age of 53 years (range: 23-82); a family history of cancer in 2; breast pain in 9; the average time to consultation of 8 years (6-24); gynecomastia found in 1; the tumor palpable in all 14 (size of 5 cm [3-10]); ulceration in 5. The most common histological type was non-specific infiltrating carcinoma with 92.8%. SBR II grade was found in 78.5% of cases. Of 8 patients with immunohistochemistry, hormone receptor positive was in 13 and Her2 positive was in 5. Metastases were found in 4, 2 pulmonary and 2 hepatic. Treatment: Neoadjuvant chemotherapy in 21.4%; radical surgery in 13 cases; surgery + radiotherapy in 2; surgery + hormonal therapy in 4. After an average follow-up of 36 months, 1 patient developed a lung metastasis and another patient had a lymph node recurrence. Conclusion: Male breast cancer was detected at relatively later stages. Physicians must be aware of this condition.
Surgical Science
Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolis... more Through its impact on morbidity and mortality and the cost of medical care, Venous Thromboembolism (VTE) has a significant influence on the quality of care in a surgical environment. The objectives were to determine the risk of postoperative venous thromboembolism and to assess its prophylactic management in the general surgery department of Gabriel Toure University Hospital. This was a prospective observational study from May 01, 2018 to December 31, 2018. It included all patients of 18 years old and over, operated in regulated surgery, under general anesthesia in the department. For all of these patients, Caprini score was used to assess the risk of VTE. The ninth American College of Chest Physicians’ Consensus was used as guidelines to assess Thromboprophylaxis practices in the ward. The Caprini score was evaluated in 80 patients for 8 months. The average age was 50.2 years. The sex ratio was 0.48. The risk level of VTE was low in three patients (3.8%), moderate in 13 patients (16.3%), high in 34 patients (42.5%) and highest in 30 patients (37.5%). The main risk factors found were major surgery (87.5%), age > 40 years (72.5%), cancer (33.8%), bed rest (31.2%), obesity (27.5%) and minor surgery (12.5%). Early mobilization was performed in all patients. Pharmacologic prophylaxis was required in 80% of our patients but only 38.8% had received low molecular weight heparin. VTE complicated 5 procedures, including 3 cases of deep vein thrombosis of the limbs and 2 cases of pulmonary embolism who died. Venous thromboembolism is serious and common in surgical settings. Its prevention remains insufficient in our context.