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Total or partial thyroidectomy has been proposed as the initial treatment for benign euthyroid oiter. The aim of this study is to determine the complications associated with surgical procedures for goiter, based on our experience. Material and method: A retrospective study over 10 years concerning 409 patients operated on for goiters in the department with 48 cases of complications. Results: 409 patients operated on for goiter in the department with 48 cases of complications (11.82%). The per- and post-operative complications were: hemorrhage (18: 4.40%), recurrent lesions (1; 0.24%), 8 cases of infection (1.96%), 5 cases of transient hypocalcemia (1.22%) and phonation disorders 9 cases (2.20%). Conclusion: Complications from goiter surgery seem to be more related to thyroid disease and the surgeon’s experience than to the surgical procedure. Better knowledge of the factors leading to complications will improve the outcome of goiter surgery.

Aim: The purpose of this study was to determine the frequency of the hurts of the inferior laryngeal nerve, according to its anatomical reports with the inferior thyroid artery during the thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery “B” to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the Teaching Hospital “Mother-Child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were retained. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the inferior laryngeal nerve realized during the surgical operations on the thyroid, the frequency of lesion of the inferior laryngeal nerve was 1.09% (20 cases) when it passed dorsally with regard to the inferior thyroid artery (1837 cases) and when 4.04%, it was transvascular or prevascular (272 cases). Conclusion: The prevascular route or transvascular of the inferior laryngeal nerve favors its lesion per operating.

Introduction: Laparoscopic cholecystectomy is the gold standard in the treatment of gallstones and lithiasis cholecystitis. It reduces post-operative complications especially in sickle cell patients. Aim: The aim of this work was to compare the results of laparoscopic cholecystectomy in sickle cell and non-sickle cell patients. Methods: Sixty-six patients including 25 sickle cell patients and 41 non-sickle cell patients were identified from March 2013 to November 2014 (20 months). The χ2 test was used for comparisons. Values of p

We conducted a retrospective study that included patients with erythrocyte and hemolytic pathology justifying a splenectomy and patients presenting splenic trauma for which hemostasis splenectomy is required. We performed 27 total splenectomy in which 26 are by laparotomy (92.86%) and 1 by laparoscopy (3.57%). A partial splenectomy was performed by laparoscopy. The morbidity was marked by 2 cases of infectious syndrome and 1 case severe anemia. The mortality was 7.14% (n = 2). Splenectomy is part of the therapeutic arsenal for benign or malignant hematological disorders that constitute the main indication for elective splenectomy. Splenectomy was one of the most common operations in abdominal surgery. During the past decade, an increased rate of late complications, specially septic and thromboembolic complications are well documented. The risk is related to the indication of splenectomy, and is less than 1% in adults without immunodeficiency. However, these overwhelming postsplenectomy infections are associated with a high mortality rate. The best treatment of these infections is preventive measures which are based on vaccination and education of asplenic patients.

The purpose of this study was to study the frequency of premature division of the inferior laryngeal nerve and its consequences in thyroid surgery. Methodology: We realized a forward-looking and retrospective study from January, 1979 till December, 2017 in the service of surgery B to the University hospital of the Point G of Bamako and in the service of ENT and cervico-facial surgery of the CHU “mother-child”, the Luxembourg of Bamako (Mali). All the patients operated in both services for mild goiters were included. Cancers and other thyroid pathologies were not included. The diagnosis of mild goiter was paused by the histological examination realized on all the surgical specimens. Results: On 2109 dissections of the lower laryngeal nerve realized during the surgical operations on the thyroid 95.1% of the cases, the nerve had a single branch; in 4.1% of the cases, the nerve had two branches; and in 0.8% of the cases, the nerve had more than 2 branches. Conclusion: The complications of the thyroid surgery in touch with the hurts of the lower laryngeal nerve are known. However, our study shows that these do not seem to be influenced by the premature division of the lower laryngeal nerve.

Purpose: To describe the epidemiological, clinical and therapeutic aspects of secondary hyperparathyroidism inrenal failure chronic. Patients and methods: We collected 11 cases of hyperparathyroidism secondary to renal failure terminal operated in the Service of surgery B of the Central Hospital University of Point G between December 2016 and November 2018. Results: The sex ratio was 0.22 in favor of women. The average age of the patients was 43 or 27 years with extremes of 63 and 25 years. Secondary hyperparathyroidism in renal failure chronic represented 1.9% of interventions to cold in the Service of surgery B. 100% of patients (11/11) were haemodialysis. 100% of the patients had clinical and biological signs. 45.5% (5/11) had radiological signs. The average rate of parathyroid hormone was 2413.51 pg/ml with extremes of 1264 pg/ml and 3616 pg/ml. The reference value was 15 - 65 pg/ml. The surgical technique of choice was the 7/8th parathyroidectomy in 100% of cases. The postoperative were simple in 81.8%, and complicated in 18.2%. There were no death. The average duration of postoperative follow-up was 6 months. After surgery, 50% of patients (5/10) had normal levels of parathyroid hormone and 50% (5/10) made a persistent hyperparathyroidism. Conclusion: Secondary hyperparathyroidism is a frequent complication in renal insufficient chronic in hemodialysis. Surgery is indicated in the resistant cases of medical treatment. The 7/8th parathyroidectomy is the surgical technique of choice. The rate of post operative complications is higher in our context.

The purpose of this study was to investigate the clinical and therapeutic aspects of peritonitis by perforation of gastric and duodenal ulcer. This was a retrospective and descriptive study over 8 years (2010-2018) which allowed to collect 54 cases of peptic ulcer. Included in the study were all patients with confirmed gastroduodenal perforation on histology or laparotomy. We collected 54 cases of peptic ulcer perforated s. The age group of 30 - 49 years was the majority. The male sex was dominant with 90.7% of cases; the clinical picture was dominated by abdominal contracture associated with pain in 74.07% of cases. X-ray of the abdomen without preparation (AWP) revealed in 87.03% of cases of pneumoperitoneum. The perforation was in 68.52% of cases on the gastric antrum and in 31.48% on the duodenum. The surgical procedure used was the bank of excision, and a suture reinforcement epiploic in 68.52% of cases, a simple suture made in 31.48% of cases, the disease was marked by a fistula (1.90%) and mortality was 5.55% of cases. The gastroduodenal ulcer perforation is potentially serious and responsible peritonitis whose surgical treatment involves the peritoneal toilet and sutures the puncture.

Considered as rare in Africa lithiasis of the main bile duct (MBD) is a potentially serious pathology, diagnosis is facilitated by imaging tests (ultra-sound, CT, MRI cholangiopancreatography). Its surgical management is improved by laparoscopy coupled with interventional endoscopy. However, laparotomy remains the only way in Mali. This was a 14-years retrospective and descriptive study (2010-2014). All patients with BPV lithiasis were included. We studied the field, antecedents, clinical, biological, radiological, therapeutic and outcome aspects. 40 cases of stones in the main bile duct were collected during the study period. The hospital frequency was 2.8 cases per year, the clinical signs dominated by the Charcot triad (pain, fever, jaundice) found in 40 cases (100%). The average age was 60 years, female represented 70% of cases. Ultrasonography was the most requested review in 40 cases (100%). The procedure performed was cholecystectomy associated with choledochotomy with calculation extraction in all patients (100% of cases). One case of biliary fistula and one case of wall abscess were observed. The mortality was 5% and the simple suited in 90% of the cases. The lithiasis of the main bile duct is an infrequent pathology in Mali and potentially serious. This diagnosis is assisted in our context by ultrasound and CT. Laparotomy remains the only route of entry in Mali.

Traumatic rupture of the ascending aorta is rare. We report the case of a 23-year-old man who suffered a service accident by crushing the thorax between two tanks during army maneuvers that resulted in an adventitial rupture of the ascending thoracic aorta extending to the Crosse. Treatment consisted of replacement of the ascending aorta with a 24 mm Hemashield straight tube and re-implantation of supra-aortic vessels at the dome of the prosthesis.

In 7 years, we brought together 100 cases of volvulus of the colon sigmoid to the hospital Somine Dolo of Mopti among which the handle volvule was found without necrosis in 66 cases and necrosis 34 cases. Seventy-six patients benefited from a sigmoidectomy followed by a colorectal anatomize at a time, twenty one patients of an intervention of Hartmann. A surgical distortion was realized at 3 patients. All the patients operated by these last two techniques had a restoring of the digestive continuity for an average deadline of 90 days. The post-operative complications consisted of 11 cases of parietal suppuration and a case of evisceration. The average duration of follow-up was of 210 days. The post-operative mortality was 14%. It was about a state of toxic shock with visceral multi-failure (n = 13), and of a pulmonary embolism (n = 1). The treatment of the volvulus requires a fast diagnostic and therapeutic coverage. The best treatment consists of a resection of the sigmoid as a matter of urgency followed by an immediate anastomosis if the following conditions are carried achieved: state general voucher, experimented surgeon and if the resuscitation meadow, per and post-operative can be assured.

Aim: To evaluate 15 years practice of coelioscopic Treatment of ectopicpregnancy in the Surgery Department “A” at the University Hospital Point G. Material and Methods: We conducted a descriptive retrospective study at the Surgery Department “A” at the University Hospital Point G from January 2001 to August 2015. Inclusion criteria were all pregnant women with ectopic pregnancy treated with coelioscopy. Sociodemographic, clinical, paracclinical and therapeutic aspects were recorded. Results: In 15 years, 42 cases of ectopic pregnancy out of 3840 gynecologic coelioscopies (1.04%) were collected. The average age was 28.5 years old with the extremes of 16 and 41 years old. Metrorragia was associated to pain in 83.3% (35/42); amenorrhea was found in 66.7% (28/41). Physical exam revealed pain with abdominal defense in 59.5% (25/42), adnexal mass in 31% (13/42), and pelvic contracture in 9.5% (4/42). In pre-operative, ectopic pregnancy was diagnosed complicated in 71.4% (30/42) and uncomplicated in 28.6% (12/42). Patients underwent salpingectomy in 85.7% (36/42), delivery from the fallopian tube in 9.8% (4/42), and hemostatic salpingectomy in 4.4% (2/42). The average duration of hospital stay was 1.88 day with the extremes of 1 and 7 days. The postoperative evolution was favorable in 97.6% (41/42), infection at the site of surgery was reported in 2.4% (1/42). Not a single death was registered. Conclusion: Treatment of ectopic pregnancy is of routine at the surgery department “A” in Point G. Fertility is preserved in the future.