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Ann Endocrinol (Paris). 2011 Feb;72(1):30-3. doi: 10.1016/j.ando.2010.06.002.

Benabbad I(1), Chraibi A, Iraqi H, Serji B, Mohsine R, Ifrine L, Belkouchi A, Bonnichon P, El Malki HO.

(1)Service d’endocrinologie, diabétologie et maladies métaboliques, CHU Ibn Sina, faculté de médecine et de pharmacie de Rabat, université Mohammed V Souissi, Rabat, Morocco. 

BACKGROUND: Parathyroid incidentaloma is not a well-known entity. The aim of this study was to show its incidence and to discuss its management.

METHODS: This was a prospective study analyzing cases of enlarged parathyroid glands discovered during thyroid surgery. The records of patients with parathyroid incidentaloma were reviewed. We also reviewed all cases of primary hyperparathyroidism (HPTPs) operated during the same period for comparison.

RESULTS: Three cases of enlarged parathyroid were found. No clinical or biochemical features led us to suspect hyperparathyroidism before surgery, but a  macroscopically enlarged parathyroid gland was discovered during the dissection and was removed in all three patients.

CONCLUSIONS: Enlarged parathyroid glands discovered at the time of surgery may represent an early pathological stage responsible for overt primary hyperparathyroidism. In absence of major risk for recurrent nerve palsy, we recommend removal of any enlarged parathyroid discovered during neck surgery in order to avoid the risks of future surgical procedures, preserving in the same time at least one normal parathyroid gland.

Copyright © 2010 Elsevier Masson SAS. All rights reserved.

DOI: 10.1016/j.ando.2010.06.002

PMID: 20970777  [Indexed for MEDLINE]

Mouaqit O(1), Jahid A, Ifrine L, Omar El Malki H, Mohsine R, Mahassini N, Belkouchi A.


Author information:

(1)Surgery Departement A, Ibn Sina University Hospital, Rabat, Morocco.


Gastrointestinal stromal tumors (GISTs) represent the majority of primary non-epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by immunohistochemical staining for the CD117 antigen. Extragastrointestinal stromal tumors (EGISTs), neoplasms with immunohistological  features overlapping those of GISTs, are found in the abdomen outside of the gastrointestinal tract with no connection to the gastric or intestinal wall. The  present report presents the clinical, macroscopic and immunohistological features of an EGIST arising in the greater omentum of a 63-year-old woman, and discusses  the clinical behavior and prognostic factors of such lesions in comparison to their gastrointestinal counterparts.


Copyright © 2011 Elsevier Masson SAS. All rights reserved.


DOI: 10.1016/j.clinre.2010.11.012

PMID: 21349787  [Indexed for MEDLINE]


Clin Res Hepatol Gastroenterol. 2011 Sep;35(8-9):590-3. doi: 10.1016/j.clinre.2010.11.012. Epub 2011 Feb 23.

El Malki HO, Souadka A, Benkabbou A, Mohsine R, Ifrine L, Abouqal R, Belkouchi A.


BACKGROUND: The management of liver hydatid cysts is controversial. Surgery remains the basic treatment, and can be divided into radical and conservative approaches. The purpose of this study was to compare the results of radical and conservative surgery in the treatment of liver hydatid cysts.

METHODS: Data from all patients with liver hydatid cyst treated in a hepatobiliary surgical unit, between January 1990 and December 2010, were retrieved from a retrospective database. To minimize selection bias, propensity score matching was performed, based on 17 variables representing patient characteristics and operative risk factors. The primary outcome measure was hydatid cyst recurrence.

RESULTS: One hundred and seventy patients were matched successfully, representing 85 pairs who had either a radical or a conservative approach to surgery. At a median (i.q.r.) follow-up of 106 (59–135) and 87 (45–126) months in the radical and conservative groups respectively, the recurrence rate was 4 per cent in both groups (odds ratio (OR) 1.00, 95 per cent confidence interval 0.19 to 5.10). There were no statistically significant differences between conservative and radical surgery in terms of operative mortality (1 versus 0 per cent; P=0.497), deep abdominal complications (12 versus 16 per cent; OR 1.46, 0.46 to 3.49), overall postoperative complications (15 versus 19 per cent; OR 1.28, 0.57 to 2.86), reinterventions (0 versus 4 per cent; P=0.246) and median hospital stay (7 (i.q.r. 5–12) days in both groups; P=0.220).

CONCLUSION: This study could not demonstrate that radical surgery reduces recurrence and no trend towards such a reduction was observed.


PMID: 24843869  [Indexed for MEDLINE]


Br J Surg. 2014 May;101(6):669-75.

Benkabbou A, Souadka A, Serji B, Hachim H, El Malki HO, Mohsine R, Ifrine L, Belkouchi A.


BACKGROUND: Over past decades laparoscopic liver resection (LLR) has gained wide  acceptance among hepatobiliary surgeons community.

To date, few data are available concerning LLR programs in developing countries. This study aimed to assess feasibility and safety of LLR in a Moroccan surgical unit.

METHODS: From June 2010 to February 2013, patients that received LLR were identified from a prospective « liver resection » database and included in this study. Parenchymal transection was performed using Harmonic scalpel and bipolar clamp with no Intraoperative ultrasound use or systematic pedicle clamping. LLR difficulty was categorized into 3 categories according to Louisville-statement (I-III). Demographic informations, liver lesion informations, operative details, pathological tumor-margin and 1-months postoperative morbidity according to Clavien-Dindo(C-D) classification were analyzed.

RESULTS: Among 104 patients who underwent liver resection 13(12,5%) had LLR. There were 7 females and 6 males with mean age of 57,5 ± 17 years. LLR was performed for benign lesions in 3 cases and malignant ones in 10 (77%) patients:  hepatocarcinoma in 7 patients and synchronous rectal-liver metastasis in 3 patients. Lesions were solitary in 12 (92%) patients with median size of 50mm (15 mm-150 mm). Patients with liver metastasis received combined laparoscopic rectal  and liver resection. We used pure laparoscopic approach in 12 (92%) patients and  hybrid one in 1 patient. LLR difficulty was category I, II and II in respectively 3(23%), 6(46%) and 4(31%)patients. Conversion rate to open liver resection was 15%. Mean blood loss was 395 min ± 270 min with no hepatic pedicle clamping or peroperative blood transfusion. All resections were tumor free margin. Mortality  rate was nil and morbidity occurred in 4(30%) patients: ascites (C-D 2) and pelvic sepsis in combined resections (CD 3b). Median hospital stay was 6 days.

CONCLUSION: Laparoscopic liver resection in our context is safe in selected patients, since no operative mortality, blood transfusion requirement or palliative resection was recorded and liver related morbidity rate was low. Intraoperative ultrasound liver examination capacities are mandatory to improve laparoscopic liver resection program’s quality and extend indications.

PMID: 26815517  [Indexed for MEDLINE]

Tunis Med. 2015 Aug-Sep;93(8-9):523-6.

Serji B(1), Souadka A(2), Benkabbou A(2), Hachim H(2), Jaiteh L(2), Mohsine R(2), Ifrine L(2), Belkouchi A(2), El Malki HO(3).


Author information:

(1)Surgery Department ‘A’, Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco; Medical School, Mohammed the First University, Oujda, Morocco.

(2)Surgery Department ‘A’, Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco.

(3)Surgery Department ‘A’, Ibn Sina Hospital, Medical School, Mohammed V University in Rabat, Morocco; Medical Centre of Clinical Trials and Epidemiological Study and Biostatistical, Clinical Research and Epidemiological Laboratory, Medical School, Mohammed V University in Rabat, Morocco; Abulcasis International University of Health Sciences, Abulcasis Medical School, Rabat, Morocco.


OBJECTIVE: To verify the feasibility and safety of laparoscopic adrenalectomy for large tumours, as since it was described, the laparoscopic approach for adrenalectomy has become the ‘gold standard’ for small tumours and for large and  non-malignant adrenal tumours many studies have reported acceptable results.

PATIENTS AND METHODS: This is a retrospective study from a general surgery department from January 2006 to December 2013 including 45 patients (56 laparoscopic adrenalectomies). We divided patients into two groups according to tumour size: <5 or ⩾5 cm, we compared demographic data and peri- and postoperative outcomes.

RESULTS: There was no statistical difference between the two groups for conversion rate (3.7% vs 11.7% P = 0.32), postoperative complications (14% vs 12%, P = 0.4), postoperative length of hospital stay (5 vs 6 days P = 0.43) or mortality (3.5% vs 0% P = 0.99). The only statistical difference was the operating time, at a mean (SD) 155 (60) vs 247 (71) min (P < 0.001).

CONCLUSION: Laparoscopic adrenalectomy for large tumours needs more time but appears to be safe and feasible when performed by experienced surgeons.


DOI: 10.1016/j.aju.2016.04.003

PMCID: PMC4963158

PMID: 27489741


Arab J Urol. 2016 May 19;14(2):143-6. doi: 10.1016/j.aju.2016.04.003. eCollection 2016 Jun.

Souadka A(1), Naya MS(1), Serji B(1), El Malki HO(1), Mohsine R(1), Ifrine L(1),  Belkouchi A(1), Benkabbou A(1).


Author information:

(1)Surgical Department A, Ibn Sina Hospital, Faculty of Medicine, Mohammed V University in Rabat, Morocco.


INTRODUCTION: Resident participation in laparoscopic cholecystectomy (LC) is one of the first steps of laparoscopic training. The impact of this training is not well-defined, especially in developing countries. However, this training is of critical importance to monitor surgical teaching programmes.

OBJECTIVE: The aim of this study was to determine the impact of seniority on operative time and short-term outcome of LC.

DESIGNS AND SETTINGS: We performed a retrospective study of all consecutive laparoscopic cholecystectomies for gallbladder lithiasis performed over 2 academic years in an academic Surgical Department in Morocco.

PARTICIPANTS: These operations were performed by junior residents (post-graduate year [PGY] 4-5) or senior residents (PGY 6), or attending surgeons assisted by junior residents, none of whom had any advanced training in laparoscopy. All data concerning demographics (American Society of Anesthesiologists, body mass index and indications), surgeons, operative time (from skin incision to closure), conversion rate and operative complications (Clavien-Dindo classification) were recorded and analysed.

One-way analysis of variance, Student’s t-test and Chi-square tests were used as appropriate with statistical significance attributed to P < 0.05.

RESULTS: One hundred thirty-eight LC were performed. No differences were found on univariate analysis between groups in demographics or diagnosis category. The overall rate of operative complications or conversions and hospital stay were not significantly different between the three groups. However, mean operative time was significantly longer for junior residents (n = 27; 115 ± 24 min) compared to  senior residents (n = 37; 77 ± 35 min) and attending surgeons (n = 66; 55 ± 17 min) (P < 0.001).

CONCLUSION: LC performed by residents appears to be safe without a significant

difference in complication rate; however, seniority influences operative time.

This information supports early resident involvement in laparoscopic procedures and also the need to develop cost-effective laboratory training programmes.


DOI: 10.4103/0972-9941.186687

PMCID: PMC5363119

PMID: 28281477


J Minim Access Surg. 2017 Apr-Jun;13(2):131-134. doi10.4103/0972-9941.186687.

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