[Continent esoduodenal intubation after total gastrectomy for cancer. An African experience apropos of an initial series of 17 cases]. / L'intubation oeso-duodénale continente après gastrectomie totale pour cancer. Expérience africaine à propos d'une série préliminaire de 17 cas.

On the basis of a series of 17 cases in which GI continuity was restored by a containing esoduodenal intubation, the authors describe the technique, which consists in the approximation of the duodenum opposite the diaphragm. Esophageal intubation in the duodenum, the margins of which have been everted, allows preserving the physiological circuit, producing a new container within 3 months and ensuring an effective protection against reflux. The 17 patients had undergone total gastrectomy for advanced cancer, Gutman's stage II in 80% of all cases and stage III or more in the other 20%. 88% of the tumors were adenocarcinomas. There were no clinical or radiological signs of reflux, and no esophagitis was noted on repeated endoscopies. The postoperative mortality rate was 5.8%. The shortest time lapse is 1 year.

[Highly malignant tumors of the uterine corpus at the Hospital Principal in Dakar. Apropos of 8 cases in 1986-1987]. / Tumeurs corporéo-utérines de haute malignité à l'Hôpital Principal de Dakar. A propos de 8 cas en 1986-1987.

8 observations of corporeo-uterine tumors, observed during 2 years (1986-1987) at the Hospital Principal of Dakar (Senegal), are expounded. Their connected chemical, surgical and evolutive expression allowed us to gather 4 "Carcinoma" (epithelial malignant tumours), 2 sarcomas (conjunctival malignant tumours) and 2 uterine corpus extensive choriocarcinoma (trophoblastic tumours). Late detected, unfortunately developed, these tumours are characterized by their high seriousness and the appalling prognosis they mean (the victim doesn't generally survive more than 10 months).

[Right ileocolonic intubation after resection of the terminal ileum for generalized peritonitis caused by ileal perforation. An African experience with 33 cases]. / Intubation iléo-colique droite après résection de l'iléon terminal pour péritonite généralisée par perforation iléale. Expérience africaine de 33 cas.

Generalized peritonitis due to ileal perforation is common in Africa, and is caused by typhoid fever in most cases. For various reasons, the patients arrive at hospital in a poor general condition. In spite of combined intensive care and surgery, the general evolution of the disease resulted in a high mortality rate. All surgical techniques requiring sutures on a poor-quality ileon, ie. excision and suture, limited segmental resection or extensive ileal resection, most often lead to the breakdown of suture lines, so that the patient enters the vicious circle of repeated peritonitis and hazardous re-operations. Even exteriorized suture lines turn into fistulae, and temporary terminal ileostomy requires an amount of maintenance that is sometimes difficult to ensure in Africa. The technique proposed by the authors was developed in the department of surgery of the Dakar Main Hospital and has several advantages: It is a simple and quick procedure, which does not require the surgeon to be very experienced and can be performed in underequipped hospitals. There is no procedure-associated mortality. Morbidity decreases as the surgeon's experience increases. GI continuity can be established even in a septic environment. No second-look operation is necessary, so that the stay at hospital becomes shorter and the costs of treatment lower. Lastly, this type of restoration can be applied to other indications such as right colectomy and ileocolic or transverse ileal intubation.

[Post-traumatic cubitus varus in children. Apropos of 8 cases in African children]. / Le cubitus varus post-traumatique chez l'enfant. A propos de 8 cas chez l'enfant Africain.

The authors relate their experience with 8 cases of management of post-traumatic cubitus varus in the Africa child. In this series the mean varus angle, sense stricto, irrespective of the physiological valgus, was 24 degrees with extreme values ranging 10 degrees-45 degrees. Indication for surgery has always rested with the true varus value and with the degree of resulting esthetic and functional prejudice. Resection of an external bone wedge combined with synthesis using two crossed rods yielded good results, and rehabilitation was started as early as the first month after surgery.

[Vaginal hysterectomy: its place in surgical practice overseas as related to the experience of the Principal Hospital of Dakar]. / L'hystérectomie vaginale: sa place en pratique chirurgicale outre-mer à propos de l'expérience de l'Hôpital Principal de Dakar.

The authors report on their surgical practice of vaginal hysterectomy at the Principal Hospital of Dakar. First, they assign a place to the frequency of this technic. Then, they recall the major technical details, underlining advantages and limits. They conclude in favour of better knowledge and performing this technic more often, while recognizing some limits related to the pathologic context overseas.

[Surgical pelviperitonitis and the African gynecologic complex]. / Pelvipéritonites chirurgicales et complexe gynécologique africain.

From the analysis of 28 records in the gynecological Department of the Hospital Principal in Dakar, all of them recording cases of pelviperitonitis having demanded a surgical intervention, it seems permissible to the authors to maintain the denomination, full of imagery, of "Gynecologic African Complex". They define it as appearing in a peculiar socio-economical environment (in Africa but also in the Third World) and characterised anatomically by an inflammatory pelviperitoneal syndrome presenting a large anatomic diversity. In the studied records, the authors sorted out 14 cases with an acute clinical aspect and 14 with a chronic one. These 28 cases represented 1.5% of the admissions and 5% of the operated patients in the gynecologic Department. The aspect "complex", linked with the polymorphism of the diagnosed lesions (among them 2 tubal tuberculosis, 1 peritoneal tuberculosis, 2 genital bilharziosis) and their frequent association, constitutes a surgical entity about which therapeutic tactics has to be adapted and reasonably mutilating. The concern of preservation must take into consideration future evolution of surgical consequences, genital and obstetrical future of women often young.