[Indications and results of pulmonary resections in a developing country]. / Indications et résultats des exérèses pulmonaires dans un pays en développement.

INTRODUCTION: Indications for pulmonary excision are dominated by infectious pulmonary pathologies in developing countries. We conducted this study to describe the indications and results of pulmonary resections in the thoracic surgery department of the Mali hospital. PATIENTS AND METHODS: This is a retrospective and descriptive study from January 2012 to December 2019, carried out in the thoracic surgery department of the Mali hospital. It involved 76 patients who had a pulmonary resection. The variables studied were the epidemiological data, the operating indications, the therapeutic data and the prognosis. RESULTS: The mean age of the patients was 35.5 years. The sex ratio was 1.7. The average consultation time in thoracic surgery was 11.6 months with extremes of 7 days and 96 months. A history of pulmonary tuberculosis was noted in 46.1% of patients. The main indications for pulmonary resection were infectious parenchymal destruction in 64.5%, bullous dystrophy in 14.5%, bronchopulmonary cancer in 11.8% and thoracic trauma in 4% of the cases. The procedures performed were: a lobectomy (39.5%), atypical resection (36.8%), culminectomy (7.9%) and pneumonectomy (15.8%). Morbidity was dominated by thoracic empyema (9.2%) postoperative hemorrhage (5.2%), parietal suppuration (7.8%) and bronchopleural fistula (1.3%). The average length of hospital stay was 14.3 days. Mortality was 10.5%. There was a statistically significant correlation between pneumonectomy and deaths (P=0.01). CONCLUSION: Infectious lung destruction is the main indication for pulmonary resection in Mali. The consultation period is quite long. Morbidity and mortality remains high.

Acute appendicitis due to schistosomiasis: four cases at the Yalgado Ouédraogo University Hospital of Ouagadougou.

Acute appendicitis is a frequent pathology with diverse causes. Although Burkina Faso is a tropical country with endemic schistosomiasis, bilharzial appendicitis remains rare. We report 4 cases of appendicitis due to schistosomiasis that we treated at the university hospital of Yalgado Ouédraogo to call attention to the need for routine review of appendectomy parts. Four male patients, aged 22, 26, 30, and 35 years old, were admitted for abdominal pains. Eosinophilia was observed in one case. The preoperative diagnosis was acute appendicitis in 2 cases and appendiceal peritonitis in 2 others. Appendectomy was performed in all cases. Pathological examination of the appendectomy piece observed acute suppurative appendicitis due to schistosomiasis, specifically, Schistosoma haematobium. All patients received praziquantel for antiparasite treatment. Clinical course was uncomplicated in all cases. Routine antiparasite treatment would make it possible to prevent these cases of bilharzial appendicitis. In addition, routine histologic examination of appendectomy parts would enable us to determine the real frequency of this disease in our country, where bilharziasis is endemic. The treatment is appendectomy and the prognosis is good.