seydou togo | Universite des Sciences de Techniques et de technologies de Bamako (original) (raw)
Papers by seydou togo
Annals of Clinical and Laboratory Research, 2015
A significant proportion of cases of tracheobronchial foreign body aspiration due to life-threate... more A significant proportion of cases of tracheobronchial foreign body aspiration due to life-threatening condition is observed during childhood and still one of the most common pediatric emergencies. We report the case of a 4 year-old male child who aspirated a shaped metallic foreign body placed in his mouth while playing magic in school, highlighting prevention via parental education and avoidance of objects that produce the greatest risk with children. The clinical presentation was cough, sputum and chest pain which was relieved almost instantly after aspiration. Early diagnosis and treatment with rigid bronchoscopy under general anesthesia should be performed by experienced personnel in patients suspected of foreign body aspiration to avoid life threatening respiratory sequelae. There is a need of exercise caution by parents in the handling of their children.
Journal of Clinical Research and Case Studies, Jun 29, 2023
Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains ... more Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains the most widely used technique for the correction of diseases affecting this aortic segment [1]. Although mechanical valves are usually used, they expose patients to the risk of thromboembolic complications associated with anticoagulation. We report on the first Tirone David procedure performed at the Festoc center in Bamako. A 60-year-old patient was referred to us for dilatation of the ascending aorta in the context of stage 3 dyspnea. Physical examination revealed a Musset's sign and a diastolic murmur of intensity 3/6 at the aortic focus. Ultrasound revealed severe aortic insufficiency associated with dilation of the ascending aorta, with the aortic annulus measured at 23.5 mm, the sinus at 50 mm and the sino-tubular junction at 61 mm. Thoracic angioscan showed a saccular aneurysm of the initial segment of the ascending aorta. Coronary angiography was normal. Surgery was performed to replace the ascending aorta, preserving the aortic valve and re-implanting the coronary arteries. The postoperative course was marked by the onset of a haemorrhagic syndrome with pre-buffering, which prompted repeat surgery 24 hours after the first operation. The outcome was favorable, with the drains removed 48 hours later.
Revue africaine de chirurgie et spécialités, 2014
Les liposarcomes primaires du mediastin (LPM) sont des tumeurs extremement rares. Nous rapporton... more Les liposarcomes primaires du mediastin (LPM) sont des tumeurs extremement rares. Nous rapportons un cas chez une patiente de 39 ans qui a ete mal diagnostiquee et prise en charge initialement pour pleuresie puis secondairement pour tumeur broncho-pulmonaire. La tumeur occupait la cavite pleurale gauche et comprimait le parenchyme pulmonaire. Une thoracotomie exploratrice puis exerese totale de la tumeur a ete realisee avec succes. La tumeur etait d’origine mediastinale. Le resultat de l’examen anatomopathologique realise a conclu a un liposarcome bien differentie. Mots cles : Liposarcome, mediastin, cavite pleurale. Primary liposarcoma of the mediastinum are extremely rare tumors. Here in we describe a 39- year-old woman who was misdiagnosed and managed for pleural liquid then secondary for pulmonary tumeur. The huge tumor occupied the left pleural cavity, with the left lung totally compressed. the patient underwent an exploratory thoracotomy, followed by a successful tumor total removal. Result of pathologic examination showed that the tumor was well differentiated liposarcoma. Keys words : Liposarcoma, mediastinum, hemithorax.
Revue africaine de chirurgie et spécialités, 2014
Le but de ce travail etait d’evaluer les resultats de la videothoracoscopie dans les pleuresies p... more Le but de ce travail etait d’evaluer les resultats de la videothoracoscopie dans les pleuresies purulentes a travers notre pratique courante. De 2005 a 2013, notre etude retrospective a permi de colliger 33 patients pris en charge chirurgicalement par videothoracoscopie. Les patients ont ete repartis en deux groupes, ceux qui ont acheve la procedure par videothoracoscopie et ceux qui ont eu une conversion en thoracotomie. Trente trois patients ayant ete l’objet d’une videothoracoscopie pour pleuresies purulentes apres echec du traitement medical, avec une predominance masculine (ratio 3,71) et un âge moyen de (58 16,27), ont ete repartis entre le stade II et stade III avant la chirurgie (23 cas soit 69,7% et 10 cas soit 30,3%) et au moment de la chirurgie (16 cas soit 48,5% et 17 cas soit 51,5%). Le taux de conversion en thoracotomie a ete de 30,3%. En comparant le groupe thoracoscopie seule et le groupe conversion en thoracotomie, il est apparu que seul le stade de la pleuresie purulente a constitue un facteur determinant dans la conversion (p<0,001). Nous avons egalement trouve une discordance entre la classification pre-operatoire et la classification post-operatoire de la pleuresie. Trois (3) patients de stade II ont ete operes par thoracoscopie seule et trois (3) ont eu une re-intervention pour recidive ; la mortalite etait nulle. La videothoracoscopie a ete une technique performante dans la prise en charge des pleuresies purulentes, tant sur le plan diagnostique que sur le plan therapeutique avec une morbidite et une mortalite faibles. Mots cles : pleuresies purulentes, videothoracoscopie, conversion. English Abstract To evaluate the results of videothoracoscopy approach in thoracic empyema through our practice. From 2005 to 2013, our retrospective study with prospective collection of data allowed to record 33 patients who underwent surgery by taking videothoracoscopy. We have divided the patients into two groups, those who have completed the procedure videothoracoscopy and those who needed a conversion to thoracotomy. 33 patients underwent videothoracoscopy for empyema after failure of medical treatment, with a male predominance (ratio 3.71) and an average age (58 16.27); divided between stage II and stage III before surgery (23 cases or 69.7%, and 10 cases or 30.3%) and at the time of surgery (16 cases or 48.5%, and 17 cases or 51.5%). The conversion rate to thoracotomy is (30.3%). Thoracoscopic group versus conversion group to thoracotomy, it appears that only the stage of empyema was the sole factor in the conversion (p <0.001). We also found a difference between the preoperative classification and the classification postoperatively. Three patients with stage II operated by thoracoscopy alone and three had a reoperation for recurrence, mortality was null. The videothoracoscopy approach seems to be effective in the management of empyema, both diagnostic and therapeutic terms with a low morbidity and mortality. Key words : empyema, videothoracoscopy, conversion
Journal of Pulmonary and Respiratory Medicine, 2015
Revue Des Maladies Respiratoires, Mar 1, 2021
Resume Introduction Les indications des exereses pulmonaires sont dominees par les pathologies pu... more Resume Introduction Les indications des exereses pulmonaires sont dominees par les pathologies pulmonaires infectieuses dans les pays en developpement. Cette etude a ete menee afin de decrire les indications et les resultats des resections pulmonaires. Patients et methodes Il s’agit d’une etude descriptive avec collecte retrospective de janvier 2012 a decembre 2019, realisee dans le service de chirurgie thoracique de l’hopital du Mali. Elle a concerne 76 patients ayant eu une resection pulmonaire. Resultats L’âge moyen des patients etait de 35,5 ans. Le delai moyen de consultation en chirurgie thoracique etait de 11,6 mois. Les principales indications de resections pulmonaires etaient une destruction parenchymateuse infectieuse dans 64,5 % ; une dystrophie bulleuse dans 14,5 % et un cancer bronchopulmonaire dans 11,8 % des cas. Les gestes realises ont ete : une lobectomie (39,5 %) ; une resection atypique (36,8 %) ; une culminectomie (7,9 %) ; et une pneumonectomie (15,8 %). La morbidite etait dominee par l’empyeme thoracique (9,2 %) et l’hemorragie postoperatoire (5,2 %). La duree moyenne d’hospitalisation etait de 14,3 jours. La mortalite etait de 10,5 %. Conclusion La destruction pulmonaire infectieuse represente la principale indication de resection pulmonaire. Le delai de consultation est assez long. La morbi-mortalite reste elevee.
PubMed, 2015
Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the ... more 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.
PubMed, 2016
The aim of this study was to evaluate the surgical treatment of goiter in the «A» surgical depart... more 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.
Mali Médical, Sep 30, 2015
Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the ... more Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the introduction of anti-reflux system by diaphragmatic flap in Mali hospital. 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 dysphasia in 21 patients (100 %) (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.
The Pan African medical journal, 2015
Introduction: L'utilisation correcte du système clos à bouchon hépariné sur les cathéters périphé... more Introduction: L'utilisation correcte du système clos à bouchon hépariné sur les cathéters périphériques pendant les perfusions est une pratique courante dans les pays développés et aussi dans plusieurs pays en développement selon un consensus international établi. Nous comparons les résultats de la formation de thrombus et de l'infection liées au cathéter veineux périphérique chez les patients ayant bénéficié de perfusion avec système clos à bouchon hépariné (groupe expérimentale) et ceux qui ont été perfusé sans bouchon hépariné (groupe témoin). Méthodes: Nous avons colligé 100 patients hospitalisés pendant la période de Juillet 2014 à Décembre 2014 dans le service d'hospitalisation de chirurgie thoracique de l'hôpital du Mali qui ont été repartis en 2 groupes de 50 patients chacun pour une analyse comparative. L'observation du thrombus dans la lumière du cathéter est effectuée puis enregistré et tous les cathéters ont été repris pour réalisation de culture bactérienne au laboratoire dans les 2 groupes. Résultats: Dans le groupe témoin, il existe un thrombus dans la lumière du cathéter dans 36 cas (72%) et l'examen de culture bactérienne était positif dans 90%. Tandis que dans le groupe expérimental on retrouve 3 cas (6%) de thrombose du cathéter et on note une absence de germe dans l'examen bactériologique. Conclusion: L'utilisation correcte du système clos à bouchon hépariné lors des perfusions peut réduire et prévenir de façon significative les complications liées au cathéter notamment l'occlusion par thrombus, leur migration et la survenue de l'infection.
Revue Des Maladies Respiratoires, Sep 1, 2017
Pour citer cet article : Togo S, et al. Les cellulites cervico-faciales nécrosantes d'origine den... more Pour citer cet article : Togo S, et al. Les cellulites cervico-faciales nécrosantes d'origine dentaire dans un pays en voie de développement. Revue des Maladies Respiratoires (2016),
Surgery Research Journal
Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains ... more Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains the most widely used technique for correcting diseases affecting this segment of the aorta. Although mechanical valves are usually used, they expose patients to the risk of thromboembolic complications associated with anticoagulation. We report the case of the first Tirone David operation performed at the Festoc centre in Bamako. The patient was 60 years old and had been referred for dilatation of the ascending aorta in the context of stage 3 dyspnoea. Physical examination revealed a Musset's sign and a diastolic murmur of intensity 3/6 at the aortic focus. Ultrasound revealed severe aortic insufficiency associated with dilation of the ascending aorta, with the aortic annulus measured at 23.5 mm, the sinus at 50 mm and the sino-tubular junction at 61 mm. Thoracic angioscan showed a saccular aneurysm of the initial segment of the ascending aorta. Coronary angiography was normal. The o...
International Journal of Cardiovascular and Thoracic Surgery
Revue africaine de chirurgie et spécialités, 2020
![Research paper thumbnail of [Prise en charge chirurgicale des goitres hyperthyroïdiens a Bamako]](https://attachments.academia-assets.com/116653438/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...
Journal Africain d'Hépato-Gastroentérologie, 2012
ABSTRACT But Le but de cette étude était d’évaluer les résultats de la technique d’appendicectomi... more ABSTRACT But Le but de cette étude était d’évaluer les résultats de la technique d’appendicectomie par cœlioscopie dans un centre de coeliochirurgie Ouest africain. Patients et méthodes Il s’agissait d’une étude rétrospective descriptive sur une période de 115 mois (mars 2001 à septembre 2010) dans un service de chirurgie générale. Ont été inclus dans l’étude les malades opérés par voie coelioscopique pour appendicite aigue ou plastron appendiculaire refroidi. N’ont pas été retenus dans l’étude les appendicectomies par voie classique. Résultats Au total 100 malades ont été recensés soit une moyenne annuelle de 10,5 cas. L’âge moyen des patients était de 29 ans avec des extrêmes de 10 et 70 ans. La douleur spontanée et provoquée de la fosse iliaque droite a été retrouvée chez 79% des patients. L’examen échographique de l’abdomen a permis de relever 35% d’appendices inflammatoires. La classe ASA 1 était la plus représentée (68%). L’appendice était macroscopiquement inflammatoire catarrhal (51%), phlegmoneux (28%), abcédé (6%), adhérentiel (11%). Le taux de pathologies associées était de 19%. L’inflammation discrète de l’appendice s’accompagnait d’une salpingite droite, d’une torsion d’annexe droit, d’un pyosalpinx droit. La procédure technique d’appendicectomie « out » a été la plus pratiquée. Le taux de conversion a été de 4%. La mortalité a été nulle. Conclusion La pratique de l’appendicectomie par cœlioscopie dans notre contexte d’exercice nous a permis d’en mesurer tout l’intérêt. La précision diagnostique est indéniable. La technique comporte peu d’exigences. La morbidité et la mortalité sont faibles ou nulles.
Pan African Medical Journal, 2016
Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l'oesophage Endosco... more Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l'oesophage Endoscopic contribution in the dilatation of caustic esophagus stenosis
To study the results of surgical management of colon cancers in the surgery "A" department of POI... more To study the results of surgical management of colon cancers in the surgery "A" department of POINT G hospital in Bamako. This was a retrospective and descriptive study carried out in the surgery 'A' department of POINT G from January 1999 to December 2013.Were included in the study all patients operated in the department for colon cancer confirmed by histological examination. The cases of nonoperated cancers, non-cancerous tumors, other locations of cancers, and colon cancer without histological evidence have not been retained in this study. The socio-demographic profile, clinical signs, para-clinical examination, treatment modalities and postoperative follow-up are the parameters we studied. A total of one hundred twenty-one patient records were collected. Colon cancer represented 0.86% of total hospitalizations and accounted for 8.98% of digestive tract cancers. The average of colon cancer was 8.1 cases per year with a standard deviation of 2.8. The medium age of patients was 50.96 years with a standard deviation of 12.8. The sex ratio was 1.33 in favor of men. Patients consultations were dominated respectively by abdominal pain (36 cases, 29.8%), colon tumors (24 cases, 19.8%), rectal bleeding (16 cases, 13.2%) and intestinal obstruction (15 cases, 12.4%). On physical examination, an abdominal mass was found in 44.6% of patients (n = 54). Endoscopic examination revealed a budding colon tumor in 58% of patients (n = 50). Histological examination concluded to an adenocarcinoma in 94.3% of patients. Cancer was located in the left colon in 63.6% of cases (n=77) and in the right colon in 39.9% (n=41). In the aim of curative treatment, 64.5% of colon resection was definitely curative and in 14% of cases it was palliative. The treatment was only palliative in 21.5 % of cases. In 71.9 % of cases, the outcome was good. The postoperative morbidity rate was 16.5%. A total of 35 patients (29.17 %) died after surgery in the 5 years follow up. Colon cancer is a relatively common disease in our practice. The diagnosis is made late. Colonoscopy biopsy examination remains the first intention for diagnosis. The surgery is performed in first intention. The prognosis depends on the stage of the cancer.
Prise en charge d'un poly traumatisé héliporté à l'hôpital du Mali : à propos d'un cas clinique a... more Prise en charge d'un poly traumatisé héliporté à l'hôpital du Mali : à propos d'un cas clinique avec revue de la littérature Management of poly trauma helicopter at the hospital of Mali : about a clinical case and review of the literature
Annals of Clinical and Laboratory Research, 2015
A significant proportion of cases of tracheobronchial foreign body aspiration due to life-threate... more A significant proportion of cases of tracheobronchial foreign body aspiration due to life-threatening condition is observed during childhood and still one of the most common pediatric emergencies. We report the case of a 4 year-old male child who aspirated a shaped metallic foreign body placed in his mouth while playing magic in school, highlighting prevention via parental education and avoidance of objects that produce the greatest risk with children. The clinical presentation was cough, sputum and chest pain which was relieved almost instantly after aspiration. Early diagnosis and treatment with rigid bronchoscopy under general anesthesia should be performed by experienced personnel in patients suspected of foreign body aspiration to avoid life threatening respiratory sequelae. There is a need of exercise caution by parents in the handling of their children.
Journal of Clinical Research and Case Studies, Jun 29, 2023
Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains ... more Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains the most widely used technique for the correction of diseases affecting this aortic segment [1]. Although mechanical valves are usually used, they expose patients to the risk of thromboembolic complications associated with anticoagulation. We report on the first Tirone David procedure performed at the Festoc center in Bamako. A 60-year-old patient was referred to us for dilatation of the ascending aorta in the context of stage 3 dyspnea. Physical examination revealed a Musset's sign and a diastolic murmur of intensity 3/6 at the aortic focus. Ultrasound revealed severe aortic insufficiency associated with dilation of the ascending aorta, with the aortic annulus measured at 23.5 mm, the sinus at 50 mm and the sino-tubular junction at 61 mm. Thoracic angioscan showed a saccular aneurysm of the initial segment of the ascending aorta. Coronary angiography was normal. Surgery was performed to replace the ascending aorta, preserving the aortic valve and re-implanting the coronary arteries. The postoperative course was marked by the onset of a haemorrhagic syndrome with pre-buffering, which prompted repeat surgery 24 hours after the first operation. The outcome was favorable, with the drains removed 48 hours later.
Revue africaine de chirurgie et spécialités, 2014
Les liposarcomes primaires du mediastin (LPM) sont des tumeurs extremement rares. Nous rapporton... more Les liposarcomes primaires du mediastin (LPM) sont des tumeurs extremement rares. Nous rapportons un cas chez une patiente de 39 ans qui a ete mal diagnostiquee et prise en charge initialement pour pleuresie puis secondairement pour tumeur broncho-pulmonaire. La tumeur occupait la cavite pleurale gauche et comprimait le parenchyme pulmonaire. Une thoracotomie exploratrice puis exerese totale de la tumeur a ete realisee avec succes. La tumeur etait d’origine mediastinale. Le resultat de l’examen anatomopathologique realise a conclu a un liposarcome bien differentie. Mots cles : Liposarcome, mediastin, cavite pleurale. Primary liposarcoma of the mediastinum are extremely rare tumors. Here in we describe a 39- year-old woman who was misdiagnosed and managed for pleural liquid then secondary for pulmonary tumeur. The huge tumor occupied the left pleural cavity, with the left lung totally compressed. the patient underwent an exploratory thoracotomy, followed by a successful tumor total removal. Result of pathologic examination showed that the tumor was well differentiated liposarcoma. Keys words : Liposarcoma, mediastinum, hemithorax.
Revue africaine de chirurgie et spécialités, 2014
Le but de ce travail etait d’evaluer les resultats de la videothoracoscopie dans les pleuresies p... more Le but de ce travail etait d’evaluer les resultats de la videothoracoscopie dans les pleuresies purulentes a travers notre pratique courante. De 2005 a 2013, notre etude retrospective a permi de colliger 33 patients pris en charge chirurgicalement par videothoracoscopie. Les patients ont ete repartis en deux groupes, ceux qui ont acheve la procedure par videothoracoscopie et ceux qui ont eu une conversion en thoracotomie. Trente trois patients ayant ete l’objet d’une videothoracoscopie pour pleuresies purulentes apres echec du traitement medical, avec une predominance masculine (ratio 3,71) et un âge moyen de (58 16,27), ont ete repartis entre le stade II et stade III avant la chirurgie (23 cas soit 69,7% et 10 cas soit 30,3%) et au moment de la chirurgie (16 cas soit 48,5% et 17 cas soit 51,5%). Le taux de conversion en thoracotomie a ete de 30,3%. En comparant le groupe thoracoscopie seule et le groupe conversion en thoracotomie, il est apparu que seul le stade de la pleuresie purulente a constitue un facteur determinant dans la conversion (p<0,001). Nous avons egalement trouve une discordance entre la classification pre-operatoire et la classification post-operatoire de la pleuresie. Trois (3) patients de stade II ont ete operes par thoracoscopie seule et trois (3) ont eu une re-intervention pour recidive ; la mortalite etait nulle. La videothoracoscopie a ete une technique performante dans la prise en charge des pleuresies purulentes, tant sur le plan diagnostique que sur le plan therapeutique avec une morbidite et une mortalite faibles. Mots cles : pleuresies purulentes, videothoracoscopie, conversion. English Abstract To evaluate the results of videothoracoscopy approach in thoracic empyema through our practice. From 2005 to 2013, our retrospective study with prospective collection of data allowed to record 33 patients who underwent surgery by taking videothoracoscopy. We have divided the patients into two groups, those who have completed the procedure videothoracoscopy and those who needed a conversion to thoracotomy. 33 patients underwent videothoracoscopy for empyema after failure of medical treatment, with a male predominance (ratio 3.71) and an average age (58 16.27); divided between stage II and stage III before surgery (23 cases or 69.7%, and 10 cases or 30.3%) and at the time of surgery (16 cases or 48.5%, and 17 cases or 51.5%). The conversion rate to thoracotomy is (30.3%). Thoracoscopic group versus conversion group to thoracotomy, it appears that only the stage of empyema was the sole factor in the conversion (p <0.001). We also found a difference between the preoperative classification and the classification postoperatively. Three patients with stage II operated by thoracoscopy alone and three had a reoperation for recurrence, mortality was null. The videothoracoscopy approach seems to be effective in the management of empyema, both diagnostic and therapeutic terms with a low morbidity and mortality. Key words : empyema, videothoracoscopy, conversion
Journal of Pulmonary and Respiratory Medicine, 2015
Revue Des Maladies Respiratoires, Mar 1, 2021
Resume Introduction Les indications des exereses pulmonaires sont dominees par les pathologies pu... more Resume Introduction Les indications des exereses pulmonaires sont dominees par les pathologies pulmonaires infectieuses dans les pays en developpement. Cette etude a ete menee afin de decrire les indications et les resultats des resections pulmonaires. Patients et methodes Il s’agit d’une etude descriptive avec collecte retrospective de janvier 2012 a decembre 2019, realisee dans le service de chirurgie thoracique de l’hopital du Mali. Elle a concerne 76 patients ayant eu une resection pulmonaire. Resultats L’âge moyen des patients etait de 35,5 ans. Le delai moyen de consultation en chirurgie thoracique etait de 11,6 mois. Les principales indications de resections pulmonaires etaient une destruction parenchymateuse infectieuse dans 64,5 % ; une dystrophie bulleuse dans 14,5 % et un cancer bronchopulmonaire dans 11,8 % des cas. Les gestes realises ont ete : une lobectomie (39,5 %) ; une resection atypique (36,8 %) ; une culminectomie (7,9 %) ; et une pneumonectomie (15,8 %). La morbidite etait dominee par l’empyeme thoracique (9,2 %) et l’hemorragie postoperatoire (5,2 %). La duree moyenne d’hospitalisation etait de 14,3 jours. La mortalite etait de 10,5 %. Conclusion La destruction pulmonaire infectieuse represente la principale indication de resection pulmonaire. Le delai de consultation est assez long. La morbi-mortalite reste elevee.
PubMed, 2015
Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the ... more 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.
PubMed, 2016
The aim of this study was to evaluate the surgical treatment of goiter in the «A» surgical depart... more 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.
Mali Médical, Sep 30, 2015
Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the ... more Aims: To evaluate the midterm results of myotomy for achalasia by thoracotomy procedure with the introduction of anti-reflux system by diaphragmatic flap in Mali hospital. 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 dysphasia in 21 patients (100 %) (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.
The Pan African medical journal, 2015
Introduction: L'utilisation correcte du système clos à bouchon hépariné sur les cathéters périphé... more Introduction: L'utilisation correcte du système clos à bouchon hépariné sur les cathéters périphériques pendant les perfusions est une pratique courante dans les pays développés et aussi dans plusieurs pays en développement selon un consensus international établi. Nous comparons les résultats de la formation de thrombus et de l'infection liées au cathéter veineux périphérique chez les patients ayant bénéficié de perfusion avec système clos à bouchon hépariné (groupe expérimentale) et ceux qui ont été perfusé sans bouchon hépariné (groupe témoin). Méthodes: Nous avons colligé 100 patients hospitalisés pendant la période de Juillet 2014 à Décembre 2014 dans le service d'hospitalisation de chirurgie thoracique de l'hôpital du Mali qui ont été repartis en 2 groupes de 50 patients chacun pour une analyse comparative. L'observation du thrombus dans la lumière du cathéter est effectuée puis enregistré et tous les cathéters ont été repris pour réalisation de culture bactérienne au laboratoire dans les 2 groupes. Résultats: Dans le groupe témoin, il existe un thrombus dans la lumière du cathéter dans 36 cas (72%) et l'examen de culture bactérienne était positif dans 90%. Tandis que dans le groupe expérimental on retrouve 3 cas (6%) de thrombose du cathéter et on note une absence de germe dans l'examen bactériologique. Conclusion: L'utilisation correcte du système clos à bouchon hépariné lors des perfusions peut réduire et prévenir de façon significative les complications liées au cathéter notamment l'occlusion par thrombus, leur migration et la survenue de l'infection.
Revue Des Maladies Respiratoires, Sep 1, 2017
Pour citer cet article : Togo S, et al. Les cellulites cervico-faciales nécrosantes d'origine den... more Pour citer cet article : Togo S, et al. Les cellulites cervico-faciales nécrosantes d'origine dentaire dans un pays en voie de développement. Revue des Maladies Respiratoires (2016),
Surgery Research Journal
Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains ... more Surgery to replace the aortic root with a valved tube, whether mechanical or biological, remains the most widely used technique for correcting diseases affecting this segment of the aorta. Although mechanical valves are usually used, they expose patients to the risk of thromboembolic complications associated with anticoagulation. We report the case of the first Tirone David operation performed at the Festoc centre in Bamako. The patient was 60 years old and had been referred for dilatation of the ascending aorta in the context of stage 3 dyspnoea. Physical examination revealed a Musset's sign and a diastolic murmur of intensity 3/6 at the aortic focus. Ultrasound revealed severe aortic insufficiency associated with dilation of the ascending aorta, with the aortic annulus measured at 23.5 mm, the sinus at 50 mm and the sino-tubular junction at 61 mm. Thoracic angioscan showed a saccular aneurysm of the initial segment of the ascending aorta. Coronary angiography was normal. The o...
International Journal of Cardiovascular and Thoracic Surgery
Revue africaine de chirurgie et spécialités, 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...
Journal Africain d'Hépato-Gastroentérologie, 2012
ABSTRACT But Le but de cette étude était d’évaluer les résultats de la technique d’appendicectomi... more ABSTRACT But Le but de cette étude était d’évaluer les résultats de la technique d’appendicectomie par cœlioscopie dans un centre de coeliochirurgie Ouest africain. Patients et méthodes Il s’agissait d’une étude rétrospective descriptive sur une période de 115 mois (mars 2001 à septembre 2010) dans un service de chirurgie générale. Ont été inclus dans l’étude les malades opérés par voie coelioscopique pour appendicite aigue ou plastron appendiculaire refroidi. N’ont pas été retenus dans l’étude les appendicectomies par voie classique. Résultats Au total 100 malades ont été recensés soit une moyenne annuelle de 10,5 cas. L’âge moyen des patients était de 29 ans avec des extrêmes de 10 et 70 ans. La douleur spontanée et provoquée de la fosse iliaque droite a été retrouvée chez 79% des patients. L’examen échographique de l’abdomen a permis de relever 35% d’appendices inflammatoires. La classe ASA 1 était la plus représentée (68%). L’appendice était macroscopiquement inflammatoire catarrhal (51%), phlegmoneux (28%), abcédé (6%), adhérentiel (11%). Le taux de pathologies associées était de 19%. L’inflammation discrète de l’appendice s’accompagnait d’une salpingite droite, d’une torsion d’annexe droit, d’un pyosalpinx droit. La procédure technique d’appendicectomie « out » a été la plus pratiquée. Le taux de conversion a été de 4%. La mortalité a été nulle. Conclusion La pratique de l’appendicectomie par cœlioscopie dans notre contexte d’exercice nous a permis d’en mesurer tout l’intérêt. La précision diagnostique est indéniable. La technique comporte peu d’exigences. La morbidité et la mortalité sont faibles ou nulles.
Pan African Medical Journal, 2016
Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l'oesophage Endosco... more Apport des moyens endoscopiques dans la dilatation des sténoses caustiques de l'oesophage Endoscopic contribution in the dilatation of caustic esophagus stenosis
To study the results of surgical management of colon cancers in the surgery "A" department of POI... more To study the results of surgical management of colon cancers in the surgery "A" department of POINT G hospital in Bamako. This was a retrospective and descriptive study carried out in the surgery 'A' department of POINT G from January 1999 to December 2013.Were included in the study all patients operated in the department for colon cancer confirmed by histological examination. The cases of nonoperated cancers, non-cancerous tumors, other locations of cancers, and colon cancer without histological evidence have not been retained in this study. The socio-demographic profile, clinical signs, para-clinical examination, treatment modalities and postoperative follow-up are the parameters we studied. A total of one hundred twenty-one patient records were collected. Colon cancer represented 0.86% of total hospitalizations and accounted for 8.98% of digestive tract cancers. The average of colon cancer was 8.1 cases per year with a standard deviation of 2.8. The medium age of patients was 50.96 years with a standard deviation of 12.8. The sex ratio was 1.33 in favor of men. Patients consultations were dominated respectively by abdominal pain (36 cases, 29.8%), colon tumors (24 cases, 19.8%), rectal bleeding (16 cases, 13.2%) and intestinal obstruction (15 cases, 12.4%). On physical examination, an abdominal mass was found in 44.6% of patients (n = 54). Endoscopic examination revealed a budding colon tumor in 58% of patients (n = 50). Histological examination concluded to an adenocarcinoma in 94.3% of patients. Cancer was located in the left colon in 63.6% of cases (n=77) and in the right colon in 39.9% (n=41). In the aim of curative treatment, 64.5% of colon resection was definitely curative and in 14% of cases it was palliative. The treatment was only palliative in 21.5 % of cases. In 71.9 % of cases, the outcome was good. The postoperative morbidity rate was 16.5%. A total of 35 patients (29.17 %) died after surgery in the 5 years follow up. Colon cancer is a relatively common disease in our practice. The diagnosis is made late. Colonoscopy biopsy examination remains the first intention for diagnosis. The surgery is performed in first intention. The prognosis depends on the stage of the cancer.
Prise en charge d'un poly traumatisé héliporté à l'hôpital du Mali : à propos d'un cas clinique a... more Prise en charge d'un poly traumatisé héliporté à l'hôpital du Mali : à propos d'un cas clinique avec revue de la littérature Management of poly trauma helicopter at the hospital of Mali : about a clinical case and review of the literature