[Calibrated sleeve gastrectomy or sleeve gastrectomy: experiences in Abidjan]. / Gastrectomie longitudinale calibree ou sleeve gastrectomie: experience Abidjanaise.

INTRODUCTION: The aim of this study was to evaluate and analyze the first 29 cases of sleeve gastrectomy in Abidjan. PATIENTS AND METHODS: We analyzed the records of patients operated for morbid obesity in 3 private clinics in Abidjan by the team of Professor Alexandre N'Guessan from 2009 to 2014. This study included all patients who underwent laparoscopic sleeve gastrectomy for morbid obesity. RESULTS: A total of 29 patients were operated; 28 women and 1 man with a mean age of 34 years. Their body mass index (BMI) ranged between 35 and 49 kg/m2 with comorbidities. The laparoscopic procedure was possible in all cases without conversion. The average operative time was 3 hours. Patients were exeat in 70% of cases in the second postoperative day after methylene blue checks were conducted. Only 4 complications (1 phrenic abscess, 1 small bowel obstruction, 1 gastric stenosis and 1 digestive fistula) required surgical recovery. The operative mortality was 6.89%. Around 92.85% of patients had a loss of excess weight greater than 50% over 4 years, with an improvement of comorbidities. CONCLUSION: The sleeve gastrectomy is a feasible technique with our current working conditions. It requires a good patient selection, and a multidisciplinary team.

INTRODUCTION: Le but de ce travail a été d'évaluer et d'analyser les 29 premiers cas de sleeve gastrectomie à Abidjan. PATIENTS ET MÉTHODES: Nous avons évalué le dossier des patients opérés pour obésité morbide dans 03 cliniques privées d'Abidjan par l'équipe du Pr N'Guessan Alexandre de 2009 à 2014. Ont été inclus tous les patients ayant bénéficié d'une sleeve gastrectomie laparoscopique pour obésité morbide. RÉSULTATS: 29 patients ont été opérés; 28 femmes et 1 homme avec un âge moyen de 34 ans. L'indice de masse corporelle (BMI) compris entre 35 et 49 Kg/m2 avec des comorbidités. La procédure laparoscopique a été possible dans tous les cas sans conversion. La durée opératoire moyenne était de 3h. Les patients étaient exéat dans 70% des cas au 2ème jour post opératoire après un contrôle au bleu de méthylène. Quatre (4) complications (1 abcès sous phrénique, 1 occlusion du grêle, 1 sténose gastrique et 1 fistule digestive) ont nécessité une reprise opératoire. La mortalité opératoire était de 6.89%. environ 92,85% des patients avaient une perte d'excès de poids supérieure à 50% sur 4 ans, avec une amélioration des comorbidités. CONCLUSION: La sleeve gastrectomie est une technique réalisable dans nos conditions de travail. Elle nécessite une bonne sélection des patients, une équipe multidisciplinaire.

Gastrectomie longitudinale calibrée ou sleeve gastrectomie : expérience abidjanaise

Introduction : Le but de ce travail a été d'évaluer et d'analyser les 29 premiers cas de sleeve gastrectomie à Abidjan. Patients et Méthodes : Nous avons évalué le dossier des patients opérés pour obésité morbide dans 03 cliniques privées d'Abidjan par l'équipe du Pr N'Guessan Alexandre de 2009 à 2014. Ont été inclus tous les patients ayant bénéficié d'une sleeve gastrectomie laparoscopique pour obésité morbide. Résultats : 29 patients ont été opérés ; 28 femmes et 1 homme avec un âge moyen de 34 ans. L'indice de masse corporelle (BMI) compris entre 35 et 49 Kg/m2 avec des comorbidités. La procédure laparoscopique a été possible dans tous les cas sans conversion. La durée opératoire moyenne était de 3h. Les patients étaient exéat dans 70% des cas au 2ème jour post opératoire après un contrôle au bleu de méthylène. Quatre (4) complications (1 abcès sous phrénique, 1 occlusion du grêle, 1 sténose gastrique et 1 fistule digestive) ont nécessité une reprise opératoire. La mortalité opératoire était de 6.89%. environ 92,85% des patients avaient une perte d'excès de poids supérieure à 50% sur 4 ans, avec une amélioration des comorbidités. Conclusion : La sleeve gastrectomie est une technique réalisable dans nos conditions de travail. Elle nécessite une bonne sélection des patients, une équipe multidisciplinaire

[Evaluation of a four-year experience with laparoscopic surgery in Abidjan, Ivory Coast]. / Bilan de quatre années de chirurgie laparoscopique à Abidjan.

Laparoscopic surgery is now a widely accepted modality for gastrointestinal surgery. In this report the authors evaluate their four-year experience with laparoscopic surgery in a total of 494 patients in Abidjan, Ivory Coast. Cholecystectomy and appendectomy were the main indications in this series. However laparoscopic surgery has a wide range of applications in Black Africa not only for elective indications such as evaluation of chronic abdominal pain and digestive cancer but also emergency indications such as peritonitis and abdominal trauma.

[Video-assisted left colectomy for severe constipation. Description of two cases]. / Colectomie gauche cielio-assistée pour constipation morbide, à propos de deux cas.

The purpose of this report is to describe two cases involving a 43-year-old man and a 41-year-old woman who underwent laparoscopic surgery for dolichocolon causing severe constipation. In both cases the procedure consisted of left colectomy with colorectal anastomosis. There was no operative mortality or morbidity. The outcome on constipation was good. This study demonstrates the utility of laparoscopy for treatment of dolichocolon in carefully selected patents.

[Not Available].

Objective : The aim of this study was to analyse the coelioscopic surgery in appenditis. Method : We done a retrocpective study concerning 150 coelioscopic surgery in appenditis during 42 months. Result : In the study period we done more than three times coelioscopic sergery. In our study we includ 86 femals (57,3%) and 64 males (42,7%). The mean reason of surgery was tipical clinical appenditis in 124 cases (82,6%), chronic abdominal ack in 10 cases and other reasons for the last 16 cases. The appendice was take of by the "external method" in 76 cases (50,6%) "internal method" in 9 cases (6%) and the two methods in 61 cases (40,6%). In 33 cases (21,3%) the surgery of appendice was associeted with other surgery. In term of morbidity we notice three cases of parietal abces (2%). Any mortality was notice in our serial. Conclusion : Ceolioscopic sergery is a good and pratical method in appenditis tratment it allows the minimizing of hospitalisation stay.

[Crohn's disease: first report in Côte-d'Ivoire]. / Maladie de Crohn: première description en Côte-d'Ivoire.

The authors report the first case of Crohn's disease in Côte-d'Ivoire. A 20-year-old Ivorian man presented chronic diarrhea and weight loss over six years. Ulcerated lesions were found throughout the colon extending to the terminal ilieum but not involving the rectum. Diagnosis of Crohn's disease was established on radiological and histological findings. Treatment consisted of total colectomy with ileorectal anastomosis. This case is of special interest because of the extremely low incidence of Crohn's disease in black Africa.

Maladie de Crohn: premiere description en Cote-d'Ivoire

The authors rep o rt the fi rst case of Crohn's disease in Cote-d'Ivo i re. A 20-ye a r-old Ivo rian man presented chronicdiarrhea and weight loss over six ye a rs. Ulcerated lesions we re found throughout the colon extending to the terminal ilieum but not involving the rectum. Diagnosis of Crohn's disease was established on ra d i o l ogical and histological findings. Treatmentconsisted of total colectomy with ileorectal anastomosis. This case is of special interest because of the extremely low incidence of Crohn's disease in black Africa

Soave's procedure: the final sphincter-saving solution for iatrogenic rectal lesions.

BACKGROUND: Restoring intestinal continuity in the presence of radiation-induced rectal lesions and following low colorectal anastomotic complications or low Hartmann's procedure may be fraught with difficulties. Soave's procedure avoids potentially hazardous perirectal dissection. This study examined the morbidity and mortality as well as functional results. METHODS: Between January 1978 and July 1994 30 consecutive patients underwent Soave's operation as a final attempt to restore coloanal continuity. The pathology was radiation-induced lesions in 15 patients, low colorectal anastomotic complications in nine and low Hartmann's reconstruction in six. RESULTS: Mean length of follow-up was 4.2 (range 1-16) years. There was no operative mortality. Early complications included one patient with postoperative haemorrhage, one with small bowel obstruction and four with pelvic or perineal sepsis. Late complications included four incisional hernias, three anastomotic strictures which were treated by dilatation, and one recurrent ischaemic colitis. Continence was normal in 19 of 23 evaluable patients. CONCLUSION: Soave's procedure obviates the need for extensive pelvic dissection, providing good technical and functional results in both the long and short term.

Diversion-related experimental colitis in rats.

PURPOSE: Diversion-related colitis is an inflammatory process that affects the colon and/or rectum distal to a colostomy. Its mechanisms are unknown, and many hypotheses have been considered. The aim of the present study was to create an experimental model of diversion-related colitis in rats, so in the future it will be possible to test different hypotheses. METHODS: Three groups of ten male Wistar rats were used for the study. Two groups underwent a colostomy and were kept alive for 6 or 17 weeks. One group of rats was killed at the onset of the experiment. Specimens were taken in bypassed segments in the rats who had had a colostomy and in the sigmoid colon for the control group. Histologic analysis using standard coloration, histochemical techniques, and bacterial preparation was used to find histologic or changes of colonic histology or flora. RESULTS: Exclusion was associated with vascular congestion, a decrease in length of glandular crypts (P < 0.01), and an erosion of surface epithelium; inflammation of the mucosa was absent in all control animals and present in all test animals. In contrast, the number of goblet cells was not changed by the procedure. There was also a significant change in distribution and intensity of sulfomucins and sialomucins and quantitative and qualitative changes of the colonic flora. CONCLUSION: This experimental model of diversion colitis is characterized by histologic and bacteriologic modifications comparable with those reported in humans but with different histochemical changes.

[Sequela of hand burns in children: 32 cases followed and treated in the Plastic Surgery and Reconstruction department of the University Hospital Center of Treichville, Abidjan]. / Les sequelles de brûlures de la main chez l'enfant: a propos de 32 cas suivis et traités à la Consultation de Chirurgie Plastique et Reconstructrice du Centre Hospitalier Universitaire de Treichville-Abidjan.

An investigation on the effects of hand burns has been undertaken about 32 children admitted in the plastic surgery outpatients Department. Accident occurs among the lower class population and heat is the major factor pointed out. The most frequent effects are hand palmar contracture. The surgical treatment completed with the functional re-education has given very good results in 79% cases. However the cheloid contractures are the most difficult to cure. Indeed the authors insist or the prevention and the creation of a center of burned patients and a plastic surgery Service to take care of patients whose life prognostic is optimistic.

[Ileo-sigmoid knot. 16 cases]. / Le noeud iléo-sigmoïdien (ileo-sigmoid knot). 16 cas.

A retrospective study of 16 cases of ileo sigmoid knot, treated at Treichville Hospital in Abidjan Côte-d'Ivoire, is reported by the authors between 1970 and 1989. This pathology is not so seldom and concerned 14 men and 2 women from 14 years old to 61 years old with an average of 42 years. The more precise description of the physiopathology of this occlusion allows to classify this pathology as an independent entity from the other types of volvulus. The physiopathologic knowledge described allow a more precise diagnostic approach and a better codified therapeutic attitude.

[Semilunar dislocations. A report of 8 cases. (Orthopedic service-University Hospital Center of Treichville-Abidjan)]. / Les luxations du semi-lunaire. A propos de 8 observations. (Service Orthopédie-Centre Hospitalier Universitaire de Treichville-Abidjan).

The authors have underlined in a study made on 8 observations that the lunate dislocation is scar. All their patients were men under 40 years old. Industrial injury was the most dominant cause. Using WITVOET and ALLIEU's classification, they noticed a predominance of perilunar and posterior dislocations (7/8 cases). Perilunar anterior dislocations and isolated scaphoid carpal dislocation have not been encountered. The treatment which has been orthopaedic or surgical has given moderate results: Good results = 4; Average result = 1; Bad results = 2; Non seen to again = 1 The authors think that a precocious diagnosis and an orthopaedic treatment in the forms detected early and surgical treatment in ancient forms are the only guarantee of a good functional result avoiding dread diseases such as carpal instability, radiocarpal arthrosis.

[Intra-keloid excision and deferred corticoid infiltration in the treatment of keloids. University Hospital Center of Treichville-Abidjan]. / Exérèse intra-chéloïdienne et infiltration différée de corticoïdes dans le traitement des chéloïdes. (Centre Hospitalier Universitaire de Treichville-Abidjan).

On a series of 38 keloid surgery patients the authors noted a strong female predominance and the frequency of ear lobule keloid. After some rather unsuccessful excision-suture of the keloid they recommend the intra- keloid excision to be followed by a late corticoid infiltration but deferred until the 15th day. The results obtained were encouraging but some researches have to be made with regard to the etiology of this affection which might probably resolve the therapeutic problem.

[Dupuytren's contracture: review of the literature. Case report of a black African]. / La maladie de Dupuytren: revue de la litterature. A propos d'un cas chez l'Africain noir.

In one case of Dupuytren's contracture the authors make an important literature review. The affection is rare with the black man but frequent in caucasian population. Its origin is therefore european. They point out alcoholism and microtrauma due to the patient's antecedents and job.

[Skin expansion in plastic surgery. (University Hospital Center of Treichville-Abidjan)]. / L'expansion cutanée en chirurgie plastique. (Centre Hospitalier Universitaire de Treichville-Abidjan).

The skin expansion by inflatable prosthesis is a recent method to resolve insufficient tissue a short series of 7 cases. But the authors think that despite these inconveniences this technique needs to be largely diffused and used judiciously.

[Microsurgery in revascularizations and replantations of the upper extremity in emergency cases. Department of Plastic and Reconstructive Surgery. University Hospital Center of Treichville-Abidjan]. / La microchirurgie dans les revascularisations et les réplantations du membre supérieur en urgence. Département de chirurgie plastique et reconstructrice Centre Hospitalier Universitaire de Treichville - Abidjan.

The authors report their experience in vascular and nervous microsurgery. They remark that there is a long time between the emergency reception of the wounded person and the appeal to plastic surgery. They deplore also the bad collaboration between the different department of emergency surgery. Finally they emphasize that the scarcity of cases is due to insufficient information of different departments of emergency surgery in microsurgery era.

[Pheochromocytoma in black Africa. Report of 9 cases]. / Le phéochromocytome en Afrique noire. A propos d'une série de 9 observations.

Pheochromocytoma exists in black African countries with the same frequency observed in other places. The characteristics of our series of nine patients are the followings: an average age of 19, 6 years old, a sex-ratio of 1, 25, a paroxysmal high blood pressure for six patients, no MEN neither malignant tumors, the measures of V.M.A. done positively eight times, a retropneumoperitoneum scan, seven arteriographies, three echographies which were consistently positive, one death post surgery by collapsus consecutive to tumor excision, only one contralateral recurrence and positive followings in all other cases.