Publications by authors named "Georges Bwelle Moto"

3 Publications

  • Page 1 of 1

[Complications of surgical management of non-traumatic acute abdomens of digestive origin at the Yaoundé central hospital, Cameroon (November 2019 - July 2020)].

Med Trop Sante Int 2021 12 26;1(4). Epub 2021 Nov 26.

Département de chirurgie et spécialités, Faculté de médecine et des sciences biomédicales de l'Université de Yaoundé I, Cameroun.

Objective: Acute non-traumatic digestive surgical emergencies are a frequent cause of emergency in Africa. We undertook this study to investigate the morbidity and mortality of these patients in Cameroon, a developing country in Central Africa.

Patients And Methodology: This was an analytical cross-sectional study with prospective data collection, over a period of eight months (November 2019 to July 2020), at the Yaoundé central hospital (Cameroon). The latter is a second category (intermediate) public health facility in the Cameroon health pyramid, mainly welcoming patients without health insurance. All patients operated on for an acute non-traumatic digestive abdomen were included. The patients were followed up until the 12 postoperative week. We used Cox univariate regression to determine factors associated with the occurrence of postoperative complications. The significance threshold retained was 0.05.

Results: We collected 120 patients, representing 14.6% of all surgical emergencies. The mean age of the patients was 37.6 ± 13.5 years. Eighty (66.7%) were male with a sex ratio of 2. The two main preoperative diagnoses were acute generalized peritonitis (n = 58 or 48.3%) and intestinal obstruction (n = 38 or 31.7%). The two main etiologies were peptic ulcer perforation (n = 35) and acute appendicitis (n = 24). The delay between the onset of symptoms and consultation was 1.9 day and an average of 36.8 hours elapsed between diagnosis and surgery. During postoperative time the morbidity and mortality rates were 33.3 and 10%, respectively. Postoperative complications were mostly minor according to the Clavien-Dindo classification, with 21 cases of grade I (33.8%) and 12 cases of grade II (19.3%). The main cause of death was sepsis (8 out of 12 cases). We identified seven factors significantly associated with an increased risk of postoperative complications among whom three were modifiable: The consultation delay greater than 72h (p = 0.02), the time between diagnosis and the surgical intervention greater than 48h (p = 0.01) and the operating time greater than 2h (p = 0.05).

Conclusion: In our context, the results of the surgical management of acute non-traumatic abdomens of digestive origin are marked by high morbidity and mortality. The possible solutions are: the organization of public awareness campaigns to prompt rapid consultation in the event of acute abdominal pain, the establishment of universal health coverage as well as the improvement of technical platforms.
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http://dx.doi.org/10.48327/mtsi.2021.99DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9128490PMC
December 2021

Clinical epidemiology and mortality risk factors of gastric cancer in a sub-Saharan African setting: a retrospective analysis of 120 cases in Yaoundé (Cameroon).

Pan Afr Med J 2020 30;37:104. Epub 2020 Sep 30.

Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon.

Introduction: in sub-Saharan Africa, there is scare published data on cancer in general and gastric cancer in particular.

Methods: we conducted a multicenter retrospective analysis of the medical records of patients followed for gastric cancer in 5 hospital departments in the city of Yaoundé (Cameroon) over 6 years.

Results: we recorded a total of 120 patients with a mean age of 53.4 ± 13.7 years. There were 62 females (51.7%). The most common risk factors for gastric cancer in our patients was Helicobacter pylori infection (59 cases, 49.1%). Seventy-six patients (63.3%) consulted within 1 to 6 months of symptoms on set at the forefront of which chronic epigastralgia (74.1%). At endoscopy, the tumor was mostly located at the antrum and was locally advanced or metastatic in 25.8% and 58.4 of cases respectively. Adenocarcinoma was the main histologic type found in 105 (87.5%) cases. Curative treatment could only be implemented in 26.7% of patients. We noted a total of 85 deaths (70.8%) with a mean survival time of 5.91 ± 7.51 months. Survival rate at 3 and 5 years was 10.1% and 4.6%, respectively. On multivariable analysis, variables independently associated with overall survival included: WHO stage 3 performance status (p = 0.042), palpable epigastric mass on examination (p = 0.042), pyloric localization (p = 0.007), and liver metastasis (p = 0.012).

Conclusion: clinical epidemiology of gastric cancer in our study is comparable to those of other African studies with a predominance of locally advanced/metastatic forms. Prognosis is grim with diagnostic delay behind all of the identified mortality risk factors.
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http://dx.doi.org/10.11604/pamj.2020.37.104.25422DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7757231PMC
January 2021

Anal/anogenital lesion revealing child sexual abuse: A case series of an unusual situation in a black African setting.

Int J Surg Case Rep 2020 2;76:341-344. Epub 2020 Oct 2.

Department of Surgery and Subspecialties, Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon. Electronic address:

Introduction: Child sexual abuse (CSA) remains a big taboo in black Africa with an underestimated prevalence. In our context, the majority of cases are known by revelations of the child at least one year after the facts.

Presentation Of Cases: We report three cases of CSA revealed by an anal/anogenital lesion requiring surgery. All of these patients were female with ages ranging from 20 months to 8 years. The lesions encountered were: an anal abscess, a fissure-in-ano with permanent anal mucosal eversion and a complex perineal tear including partial anal sphincter rupture with partial section of the rectovaginal septum. The outcome was favorable in all cases after surgery. The abuser was subsequently able to be identified after the statements of two of these three children.

Discussion: Detection of anogenital lesions during a pediatric consultation should make practitioners aware of the possibility of sexual abuse. Surgical repair of these lesions can be simple or complex, requiring major reconstructions. In such cases, it's important to listening to the child's voice.

Conclusion: Anogenital lesions discovered during pediatric consultation must evoke sexual abuse. The silence and the taboo surrounding these abuses in Africa must be break down.
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http://dx.doi.org/10.1016/j.ijscr.2020.09.186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7569259PMC
October 2020
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