Current Issue : July-September Volume : 2025 Issue Number : 3 Articles : 5 Articles
Background: Pathologies of the ascending aorta, mainly aneurysms and dissections, represent a major challenge in cardiac surgery. The aim of this study is to report the short-term results of ascending aorta surgery in Benin. Methods: This is a prospective study of ascending aorta surgeries performed at Hubert Koutoukou Maga National University Hospital Center in Benin from March 2021 to October 2024. Results: Fifteen (15) patients were included, 11 with aneurysms and 4 with dissections of the ascending aorta, representing 11.7% of cardiac surgeries during the study period. The mean age was 50.4 ± 7.4 years, with a sex ratio (M/F) of 4. Dyspnea was the predominant symptom (66.7%). The mean left ventricular ejection fraction was 54.3% ± 9.9% and the mean left ventricular end-diastolic diameter was 68.3 ± 10.4 mm. The mean diameter of the ascending aorta was 55.0 ± 12.7 mm. The mean time of cardiopulmonary bypass was 124.5 ± 31.2 min, with a mean aortic cross-clamping time of 96.5 ± 14.4 min. Eight (8) patients underwent a Bentall procedure. A supracoronary ascending aortic replacement with aortic valve replacement was performed in 6 patients, and a Tirone David procedure in 1 patient. One patient died immediately after the operation, suffering from SARS-COV2 pneumonia. Conclusion: The indications for surgery on the ascending aorta in Benin are aneurysms and chronic type A aortic dissections. Bentall procedure is the most commonly used technique. Short-term results are relatively satisfactory....
Background/Objectives: Pre-operative radiation (Pre-RT) decreases local recurrence following soft tissue sarcoma (STS) resection but carries the risk of wound healing complications (WHCs). This study evaluated skin specimens and clinical characteristics of STS patients to (1) compare patients with and without Pre-RT, (2) compare Pre-RT patients with and without WHCs, and (3) explore associations between clinical characteristics and WHCs. Methods: This retrospective study included 54 adults who underwent STS resection with primary closure (Pre-RT n = 30). A pathologist who was blinded to the clinical outcomes evaluated the skin specimens microscopically. Results: Irradiated skin had lower vessel density and was more likely to lack hair follicles and sebaceous glands, consistent with the effects of radiation. Irradiated skin was also more likely to include plasma cells. Irradiated skin demonstrated higher mean TAZ H-scores; however, within the Pre-RT subset, those patients who developed WHCs demonstrated comparatively lower TAZ. Conclusions: This novel finding may suggest that higher TAZ in irradiated skin reflects a response to injury but that comparatively lower TAZ in irradiated skin might contribute to WHCs. Future studies should consider more focused evaluation of TAZ in STS resections with Pre-RT as they may help to predict WHCs when used in combination with other histologic factors and could suggest a therapeutic target....
Introduction: Somatotropic adenomas are benign pituitary tumors characterized by increased GH and IGF1 levels. This study aims to describe the demographic, therapeutic, clinical, and evolutionary aspects of patients with somatotropic adenoma, along with a review of the literature. Patients and Method: This retrospective study was conducted in the neurosurgery department of the Fann National University Hospital Center over six years, from 2016 to 2022, covering 18 cases of acromegaly related to a GH adenoma. Sociodemographic, clinical, paraclinical, therapeutic, and evolutionary parameters were studied. Results: The average age was 42.8 years, with a sex ratio of 2, and an average diagnosis time of 5.27 years. Clinical diagnosis was suggested by dysmorphic and tumoral syndromes, then confirmed by biological data and imaging. We found one microadenoma, 11 macroadenomas, and six giant pituitary adenomas. All patients underwent transsphenoidal surgery. Complications were mainly transient diabetes insipidus. Postoperative assessments showed 13 total excisions, three residuals, 10 visual improvements, seven stable visual statuses, and 10 cases of hormonal remission. Conclusion: Acromegaly is a clinical manifestation of GH adenomas, which remain rare. We collected 18 cases of somatotropic adenoma, all operated on with good clinical, radiological, and hormonal outcomes....
Background/Objectives: Acute ankle sprains are common injuries that significantly affect both sports and daily activities. Syndesmotic injuries, a specific type of ligamentous damage, can occur as a part of a sprain or alongside fractures, affecting approximately 20% of ankle fractures. The aim of this study was to evaluate negative prognostic factors influencing surgical outcomes in tibiofibular syndesmotic injuries associated with ankle fractures. Methods: Data from 246 patients were analyzed to examine the impact of initial ankle dislocation, fracture type, and fixation method on postoperative complications and reoperation rates. Ankle joint fractures were treated with open reduction and internal fixation using an anatomically contoured plate designed for optimal tibia and fibula fixation. Four methods of syndesmosis fixation were recorded: one three-cortical screw, one four-cortical screw, two screws (either both four-cortex screws or one three-cortex and one four-cortex screw), or one endobutton. Data analysis was performed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results: Key findings reveal no significant association between initial dislocation and the necessity for reoperation (p = 0.613). However, smoking combined with dislocation significantly increases reoperation rates (35% vs. 15.5%, p = 0.026). Fixation type influenced outcomes, with single four-cortex screws linked to pain but fewer infections. Infection was the most common complication (33.3%), predominantly after fixation with a single three-cortex screw. Men had higher rates of fixation destabilization and infections, while women experienced pain persisting beyond six months postoperatively Conclusions: Patient-specific factors influence syndesmotic injury outcomes. Smoking, gender, and fixation type impact complications, emphasizing the need for tailored surgical approaches to enhance recovery and minimize reoperation risks. Future research should aim to corroborate these findings in larger, multicentric cohorts to refine surgical strategies for syndesmotic injury management....
Background: Turner syndrome (TS) affects approximately one in 2500 live births in females. Scoliosis is one of the skeletal manifestations of TS, but most cases only require observation or conservative treatment. We experienced two adolescent TS cases in which progression of scoliosis required surgical intervention, which is very rare in TS. Case Presentation: Case 1: An 11-year-old female with TS had a single thoracic curve that rapidly progressed to a triple major curve with a 76˚ main thoracic curve at age 13.5 years. Case 2: A 14- year-old female with TS had a 59˚ single thoracic curve. In both cases, growth hormone and estrogen replacement therapy were administered preoperatively and planned postoperatively. Posterior correction and instrumented fusion using simultaneous translation on two rods technique and direct vertebral rotation with the use of multiple rod introducers were successfully performed in both cases. No crankshaft phenomenon or distal adding on were observed during those postoperative courses. Conclusions: Although curve pattern of the deformity is similar to adolescent idiopathic scoliosis (AIS), bone quality in patient with TS is lower. In the context of surgical interventions for scoliosis associated with TS, it is imperative to employ surgical techniques that take into account the suboptimal bone quality. If continuation of hormone replacement therapy is planned after corrective surgery for scoliosis in TS patients, it is essential to follow the patient closely postoperatively until bone maturation is complete....
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