The First Cases of Laparoscopic Colectomy for Cancer in Ziguinchor Peace Hospital

Laparoscopic colectomy is a standardized technique for the curative treatment of colon cancer, based on the principles of carcinological surgery. It is rarely performed in our region but common practice in developed countries. We conducted a retrospective study of the first 4 cases of laparoscopic colectomy for cancer. The patients were 3 men and 1 woman, with a mean age of 54.2 years. Of the 4 cancers, 3 were localized to the sigmoid and one to the cecum. The main symptom was rectal bleeding. Total colonoscopy with biopsy was performed in 3 patients and the histological type was a lieberkühnian, infiltrative, moderately differentiated adenocarcinoma. Thoraco-abdomino-pelvic computed tomography (TAP CT) was performed in all the cases. Three patients were presented to the multidisciplinary team (MDT) prior to surgery. The operations were one right hemicolectomy and three left hemicolectomies. The mean operative time was 182.25 min [152 - 210]. Average blood loss was estimated at 200 cc. The average hospital stay was 4.71 days. Cancer staging was classified as stage I in 1 case (p T1N0M0) and stage III in 3 cases (pT3N1Mx, pT3N2Mx). Resection margins were healthy. The number of lymph nodes removed was 12, 14, 17 and 13 respectively. Conclusion: This is a safe and reproducible technique, but requires a much higher cost than laparotomy.

Bipolar Transurethral Resection of the Prostate: Short-Term Outcome Evaluation in Regional Hospital in Senegal

Introduction: Transurethral resection of the prostate is still the most popular procedure that use for the surgical treatment of lower urinary tract symptoms due to benign prostatic obstruction in developed countries. Bipolar transurethral resection of the prostate (B-TURP) is a recent technique in our urological practice. The aim of this study was to evaluate our preliminary results on the use of a B-TURP in Kolda (Senegal) in a benign prostatic hyperplasia (BPH). Materials and Methods: This was a 15-month, retrospective and descriptive study from June 2021 to August 31, 2022. It examined the records of patients who had BPH requiring surgical treatment and who received Bipolar transurethral resection of the prostate (B-TURP) during the study period at the Kolda Regional Hospital in Senegal. We used a Karl STORZ bipolar endoscopy column with a 26 sheath and 30˚ optics. The parameters studied were the civil status of the patients, the clinical and para-clinical data as well as the operative indications. The data were entered and analyzed using Epi-info 3.5.1.1. Results: A total of 31 patients underwent bipolar transurethral resection of the prostate during the study period. The mean age of patients was 68.5 ± 12.6 years (range, 56 - 77 years). The mean total PSA was 4 ± 2.3 ng/ml (range, 0.5 - 11 ng/ml). The mean prostate size assessed by ultrasound was 54 ± 12.3 ml (range, 30 - 90 ml). The operative indication was dominated by BPH with impact on the upper urinary tract. The mean of bladder irrigation time was 21.4 ± 3.9 hours (range, 12 - 26 hours). In the immediate post-operative period, blood transfusions were performed in 2 patients (6.5%). In the medium-term follow-up, we noted one 1 (3.2%) case of urine retention requiring bladder catheterization. Conclusion: Bipolar Transurethral resection of the prostate B-TURP in saline system is efficacious and safe. The results of this preliminary study of B-TURP are satisfactory with a low complication rate. B-TURP decreases the duration of the hospitalization and the port of the probe. Our perspectives are oriented towards endoscopy of the upper urinary tract.