Les Pathologies Chirurgicales Néonatales À l'Hôpital National De Lamordé De Niamey: Aspects Diagnostiques, Thérapeutiques Et Pronostiques

Abstract

Purpose: The purpose of this study is to describe the characteristics of the newborn and its surgical pathologies managed in the service of pediatric surgery of the National Hospital of Lamordé. Patients and Methods: It is a retrospective and descriptive study within a period of 10 years (from January 1st 2007 till December 31st 2016). The epidemiological, diagnostic, therapeutic, and evolutionary aspects were also studied. Results: The surgical pathologies of the newborn child represented 12.8 % of the hospitalized patients. The average annual incidence was 47.5 newborn children a year. The average age was of 8.71 days. The newborn children were especially old from 0 to 7 days (60,2 %) and were male (66.1 %). The most frequent pathologies were the malformations anorectales (32,2 %), the omphalocele (18.3 %), and the gastrochisis (6.5 %). The surgical operations, realized for 67.7 % patients, were especially emergencies (58.2 %). The colostomy was the most realized intervention (41.9 %). The mortality rate was 25.8 % (n=123). The post-operative mortality was 16.9 % and the nonoperative mortality was 45%. The premature mortality established 70 % of deaths (n=75). The omphalocele was the main pathology supplier of death (26 %). Conclusion: The neonatal surgical pathologies are characterized by European Scientific Journal August 2017 edition Vol.13, No.24 ISSN: 1857 -7881 (Print) e -ISSN 1857 157 their frequency, their diversity, the predominance of digestive system pathologies, and a high mortality. An evaluation of pronostic factors which determines the morbi-mortality is necessary.

Congenital Malformations of the Gastrointestinal Tract in Neonates at Aristide Le Dantec University Hospital in Dakar

“…Regarding operated patients, the digestive stoma is the most performed surgical procedure in the series. [ 3 8 ] In this series, its proportion is 49.4%. It is an effective, low-cost waiting surgical procedure that can be carried out in peripheral health facilities, making it possible to improve the long-term prognosis and reduce the mortality of certain digestive anomalies with neonatal exposure.…”

“…The incidence of GIM found in our study is higher than that established by the WHO in 2010, which is 15% and varies by country. [ 1 9 ] Omid[ 3 ] explains these differences by the demographic characteristics of the populations and the specificities of pediatric surgical services depending on the country. Regarding the male predominance observed in newborns with GIM, we currently do not find an explanation for the male predominance.…”

“…Regarding the male predominance observed in newborns with GIM, we currently do not find an explanation for the male predominance. [ 3 10 ]…”

“…[ 2 ] Their prevalence varies between studies and countries and they are most often surgical emergencies. [ 3 4 ] In developed countries, the management has been dramatically improved due to antenatal diagnosis and advances in neonatal intensive care. This led to a major improvement in prognosis and reduced mortality from 50% to <10%.…”

Omphalocele: a review of common genetic etiologies

“…Ndour et al [19] reported in their series an overall mortality rate of 45.3% (less prevalent in isolated defects). In one Nigerian study, omphalocele accounted for 18.3% of the neonatal surgical pathology and the rate post-operative mortality was of 26%, while it was of 15% in one Moroccan published study [5,42]. A new insight for the type II giant omphaloceles (defects greater than 5 cm or presence of liver) is the possible conservative management at birth with delayed surgical closure of the ventral hernia after [10].…”