RESUMEN

BACKGROUND: This study described the current conditions of work of paediatric surgeons in Francophone sub-Saharan Africa (FSSA) and set the debate at the level of the humanist thinking in medicine. PATIENTS AND METHODS: This was a multicentre study from 1 st May to 30 th October 2008. The African Society of paediatric surgeons' directory was used to identify paediatric surgeons in the Francophone's countries in Sub Saharan Africa. The parameters studied were number of surgeons per country, means of training, working conditions, remunerations, needs for continuous training and the research. RESULTS: A total of 41 paediatric surgeons (68.33%) responded. The average number of paediatric surgeons per country was 5. The means of training included government scholarships among 7 paediatric surgeons (17.07%), scholarship from a non-governmental organisations in 14 (34.15%) and self-sponsorships in 20 (48.78%). The average salary was 450 Euros (€) (range: 120-1 400 Euros). Most of the paediatric surgeons (68.29%) had internet services for continuous update courses and research. Thirty six paediatric surgeons (87.80%) had no subscription to specialised scientific journals. CONCLUSION: The paediatric surgeon in FSSA faces many problems related to his working and living conditions that may have a negative impact on their competences.

Asunto(s)

Asunto(s)

RESUMEN

A wedge-shaped segment of stomach based on the right gastroepiploic artery was used for bladder augmentation in 11 patients. Initial diagnosis in these 11 patients was bladder exstrophy. Indications for the use of stomach in bladder reconstruction were important bilateral upper tract deterioration in 10 patients, dederivation in 1. A continent appendicostomy (Mitrofanoff) has been performed in all patients. In post-operative follow-up (average 24 months), all patients have stable upper tract X-rays and stable or improved renal function. All patients require intermittent clean catheterization, 8 are totally continent, 2 are partially continent, 1 patient is still incontinent. No serious digestive problem was encountered. The increase in bladder capacity was 300 to 500% after 6 months. Mucus production is reduced relative to other intestinal segments and the patients require no bladder irrigation. The authors recommend the use of stomach for urinary tract reconstruction in compromised patients.

Asunto(s)

RESUMEN

A case of postoperative necrotizing fasciitis after a right incarcerated inguinal hernia repair is reported in a six week old baby hospitalized in the paediatric surgical unit of the Yaounde General Hospital. Treatment consisted in a medical reanimation, surgical debridement and an appropriate antibiotherapy. Medical literature was reviewed and therapeutic indications discussed.

Asunto(s)

RESUMEN

The authors report their experience with posterior valves of the urethra in children. Sixty patients were seen from 1982 to 1991. The problems of diagnosis and therapy of particular importance in poor countries are emphasized.

Asunto(s)

RESUMEN

Urethral strictures in children, which are not frequent, often require urethroplasty when dilations and/ or urethrotomies have failed. A bladder mucosa graft was used successfully for urethral reconstruction to treat posterior hypospadias. We describe our experience with a bladder mucosa graft during urethroplasty for acquired urethral strictures in 8 children. Urethral strictures secondary to the treatment of hypospadias were excluded. Bladder mucosa was used successfully as an onlay or patch graft urethroplasty in 7 patients. One patient had a tubularized graft with secondary stenosis treated successfully by dilation.

Asunto(s)

RESUMEN

We describe our experience with a new technique of complete repair of severe posterior hypospadias in one stage. The operative technique includes some innovative points: penile straightening is realized by urethral mobilization (without detaching it from the glans) to excise the chordee, and then urethroplasty according to Duplay and glanuloplasty are performed. We report our preliminary results in 6 patients. They are interesting from a cosmetic and functional point of view.

Asunto(s)

RESUMEN

The physiopathology of combined volvulus of sigmoid and small intestine is discussed. In many cases a half-knot is involved, that is to say a "key" between the two ileal and sigmoid loops, difficult to describe with words but easy to understand by the use of a diagram and radiologic and intraoperative images of lesions, of possible assistance when releasing the loops or determining site of section of foot of occluded loops. Of 116 cases of sigmoid volvulus treated in the Treihville hospital, Abidjan between 1972 and 1983, eleven were associated with small intestine volvulus. Of these 11 cases, 9 were treated by emergency ideal colectomy and small intestine resection, with 3 deaths, and 2 by emergency ideal colectomy and small intestine reintegration, with 2 deaths. Operative mortality was therefore high (45%), global mortality being 24%. This is inherent in underdeveloped surgical units and will certainly improve greatly as hospital standing improves.

Asunto(s)

Asunto(s)

RESUMEN

The immunofluorescent reaction of peripheral blood cells from 10 multiple myeloma, 10 Hodgkin's and 11 lymphosarcoma cases with antiviral (Rauscher) murine leukaemia (AMR) and antihuman stem cell leukaemia plasma (AHS) antisera was studied. Cells from 25 of these patients were reactive at least once with AMR and AHS or AHS alone. Absorption studies suggested that this cytoplasmic immunofluorescent reaction involved cellular isoantigens. Serial studies on multiple myeloma, Hodgkin's and lymphosarcoma cases with significant fluorescence, showed that the fluorescent cell count variation was correlated with the presence of active disease.

Asunto(s)

Asunto(s)

Asunto(s)