P. S. DIOP1, P. S. DIOP1 1Cheikh Anta DIOP University,Departement Surgery,Dakar, DAKAR, Senegal
Introduction: : Laparoscopy has upset all fields of surgery by introducing the concept of minimally invasive surgery. It has seen its use grow, making it a tool unavoidable today especially in non-tumoral oeso-gastro-duodenal pathology. The objective of this study was to describe the epidemiological profile of patients, to report the indications and results of the treatment of non-tumoral oeso-gastroduodenal diseases by laparoscopy.
Methods: This is a retrospective study of the general surgery department of the Grand-Yoff General Hospital of Dakar during the period from 1 January 2006 to 31 December 2015. The inclusion criteria Were patients with laparoscopic non-tumor oeso-gastroduodenal disease.
Results:During the study period, 481 patients underwent laparoscopic surgery. Of these, 95 patients, 19.75%, had a non-tumoral oes-gastroduodenal disease. The average age was 41.86 years. The sex ratio was 1.05. Our series involved 16 cases of achalasia, 33 cases of hiatal hernia, 40 pyloroduodenal and 6 ulcerative stenoses. The average life span was 26.56 days. Fibroscopy was performed in all patients. The oeso-gastroduodenal transit made it possible to make the diagnosis of achalasia in all the patients concerned. All our patients diagnosed with achalasia were operated by Heller's cardiomyotomy under laparoscopy. According to Nissen-Rosseti (66%), according to Nissen (19%), according to Toupet (12%) and Dor (3%), the different therapeutic procedures in hiatal hernia were represented by the cure. In our series, 92% of our patients suffering pyloroduodenal stenosis were operated by truncular vagotomy associated with gastroenterosanitary drainage. The overall average duration of interventions was 2.11h. Our conversion rate was 9.5%. The average feeding time was 4.38 days. Morbidity was 11.6%. Mortality was zero. The mean hospital stay was 9.55 days. In the postoperative follow-up, 88.4% of the patients were classified as VISICK I and 11.6% VISICK II.
Conclusion:
Laparoscopic approach in the treatment of non-tumoral oeso-gastroduodenal conditions is possible in our exercise conditions and offers considerable advantages with low morbidity and mortality.