Browsing by Author "Basimbe, Francis"

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Combined lesser curvature gastrointestinal stromal tumor excision and sleeve gastrectomy in a bleeding obese patient: a case report
(Journal of Surgery and Medical Case Reports, 2025-08-04) Basimbe, Francis; Iman, Din Hakim; Kakooza, Francis; Musolo, Allan; Raza, Ali Ghazi
Gastrointestinal Stromal Tumors (GIST) are the most frequent submucosal lesions encountered in the gastrointestinal tract. Once encountered in the stomach, they pose several challenges in resection based on their location. Some reports have observed an increased occurrence of GISTs in obese patients, however, a correlation has not been established. Some cases of fundus Gastrointestinal stromal tumor excision during sleeve gastrectomy en-mass have been reported, however, lesser curvature GIST pose a unique challenge of fashioning the sleeve. We highlight a challenging case of excising a GIST involving the lesser curvature, followed by a sleeve gastrectomy involving the greater curvature which resulted into a unique challenge of ensuring a proper anatomical low-pressure sleeve, following endoscopic calibration. Laparoscopic excision of a gastrointestinal stromal tumor and sleeve gastrectomy involving different anatomical regions of the upper stomach can be safely performed, even in our settings, despite the challenges of fashioning a low-pressure vertical sleeve.
Gastric antral perforation with a fish bone, laparoscopic surgical intervention in a sub-saharan setting: a case series
(Annals of Case Reports and Medical Images, 2025-09-29) Basimbe, Francis; Musolo, Allan; Kakooza, Francis; Hakim, Din Iman; Tumusiime, Cresent; Najjuka, Geraldine
Foreign body ingestion is a common occurrence in clinical practice experienced in many parts of the world, especially among the pediatric population. However, their occurrence in an adult population is rare. Most foreign bodies in adults pass through the gastrointestinal tract without complications. Less than 1% cause perforation of the gastrointestinal tract and results in many complications including peritonitis, abscesses. Some foreign bodies have been known to result in perforations of different parts of the gastrointestinal tract. Yet many of these foreign bodies have been seen to pass throughout the gastrointestinal tract without causing obstruction or perforation. We highlight two cases of gastric antral perforations with abscess complications seen and managed in our setting with laparoscopic surgery approach with excellent outcomes in both these cases, we did Initially a diagnostic laparoscopy, this revealed a walled off abscess, an antral perforation and a sharp fish bone foreign bodies that were identified and retrieved from the anterior antral perforations. Lavage and antral perforation repair with omentopexy were done for both these patients. These are unusual cases of gastric antrum fishbone perforations with abscess formation seen in our setting and form the first set of documented cases managed laparoscopically with drainage of the abscess’s antral perforation repair and omentopexy with excellent outcomes. .
Human epidermal growth factor receptor 2 expression and socio-demographic, clinical, and histopathological characteristics in gastric carcinoma at St Francis Hospital Nsambya, Uganda
(PubMed Central, 2025-09-26) Wanda, Steven; Nassali, Gorretti; Bbosa, Brian; Basimbe, Francis; Akulu, Joviah; Nsamba, Davis; Nimusiima, Praise; Muhumuza, Joshua; Othieno, Emmanuel; Okuku, Dancan Maxwel
Gastric carcinoma is a significant global health burden with diverse clinicopathological features and molecular alterations influencing prognosis and treatment. Human epidermal growth factor receptor 2 (HER2) overexpression is a critical biomarker in gastric carcinoma, guiding targeted therapeutic interventions. This study aimed to assess HER2 expression and its association with clinicopathological characteristics of gastric carcinoma. A retrospective cross-sectional study was conducted using consecutive sampling to retrieve gastric carcinoma tissue blocks that met the inclusion criteria. A total of 136 formalin-fixed, paraffin-embedded tissue blocks from patients aged 18 years and above (2013–2023) at St. Francis Hospital Nsambya were analyzed. HER2 expression was evaluated using immunohistochemistry (IHC) with a standardized test kit. Associations between HER2 expression and demographic and histopathological characteristics were analyzed. Among 136 patients, the mean age was 59.63 years, with 48.53% aged 48–67 years. Most were male (63.24%) and from the Central region (60.70%). The intestinal subtype was the most common (78.68%), with 52.21% of tumors poorly differentiated, and tumors predominantly located in the antrum (32.35%), cardia (30.15%), and body (24.26%). Regarding HER2 expression, 11.76% were positive (3+), 2.21% equivocal (2+), and 86.03% negative (0 or 1+). HER2 positivity was significantly associated with residence in the Western region (aPR = 3.67; 95% CI: 1.33–10.11; p = 0.02) and with mixed-type tumors (aPR = 3.00; 95% CI: 1.70–5.30; p < 0.001). HER2 overexpression in gastric carcinoma was low. Nevertheless, the findings underscore the importance of routine HER2 testing and access to targeted therapy. Observed associations point to potential high-risk groups warranting further investigation in larger, multicenter studies.
Inguinodynia and Inguinal Hernia Recurrence Amongst Ugandan Patients Who Underwent Mesh Versus Non-mesh Inguinal Hernia Repair
(CC BY-NC-ND, 2020-11) Akim, Koma; Nassali, Gorretti; Basimbe, Francis
Introduction: The prevalence of inguinal hernia recurrence dropped tremendously with the advent of mesh hernioplasty. However, the prevalence of inguinodynia has increased. Objective: To determine and compare the prevalence of chronic postoperative inguinal pain (inguinodynia) and recurrence amongst patients who underwent mesh versus no mesh inguinal hernia repair in St. Francis Hospitals Nsambya and Naggalama in Uganda. Method: This was a cohort retrospective study conducted at St Francis Hospitals Nsambya and Naggalama. The sample size was two hundred and two patients. A consecutive sampling technique with replacement of missing charts was used. The Principal Investigator and the research assistants then made telephone calls to the patients inviting them for an interview in the two hospitals, and for those who could not attend questionnaires were administered to them on phone. This was done sequentially until the sample size for each hospital was reached. If a given telephone was not available or went unanswered, we telephoned the next patient in the sequence on the register. Inguinodynia was assessed using the Numerical Rating Pain Score (NPS). Recurrence was assessed by physical examination. Results: Two hundred and two patients were enrolled in the study. The prevalence of chronic postoperative inguinal pain amongst patients who underwent mesh versus non-mesh inguinal hernia repair were 24.4% and 8.5% respectively and the recurrence rates were 3.1% and 4.2% respectively. Conclusion: The prevalence of chronic postoperative pain amongst patients who underwent hernioplasty was higher than those who underwent non-mesh inguinal hernia repair. There was statistically no difference in recurrence rates between patients who underwent mesh versus non-mesh inguinal hernia repair in both hospitals.
Postgraduate surgical hernia training with a standardized hernia surgery training tool: training while serving humanity
(PubMed Central, 2025-10-28) Basimbe, Francis; Mubezi, Isaac; Kakande, Ignatius; Oppong, Chris; Akoh, Jacob; Tatumwa, Desmond Benjamin
The hernia surgery skills training course was first organized in 2016, after approval by the COSECSA (College of Surgeons of East, Central and Southern Africa) Executive at a meeting in Geneva, through representation by Prof. Laston Chikoya, then Chairman of the COSECSA Educational Committee. Uganda was selected as the hub of the training program, and Prof. Ignatius Kakande was charged with the responsibility of organizing it. He has successfully supervised the collaboration with Operation Hernia in organizing this course. The Operation Hernia UK-COSECSA Training Course is a comprehensive program in groin Hernia surgery and has had over six previous courses, providing residents with an invaluable training opportunity. It is a structured program with integrated competence assessment, delivered on a one-to-one basis. This model, designed by Operation Hernia and Surgeons for Africa, has also been used to train residents in Rwanda. It has been published and can be applied to other surgical specialties[1]. This study elaborates on a hernia surgery skills training program conducted with surgical residents and COSECSA fellow candidates. The training aimed to achieve an appropriate level of competence in mesh and tissue hernia surgery; train residents who complete the course to become trainers, thereby sustaining the program; and expand the program to surgical residents from other COSECSA countries using the Ugandan experience as a model. The rationale of this training follows the background of the high burden of hernias, where the prevalence of hernias in African countries is high[2,3]. And yet the rate of repair of hernias is low (10–100/100 000) compared to rates in high-income countries[4]. This gap highlights a critical need for enhanced surgical capacity and training in the region. Surgical trainees in African countries do not all have access to didactic structured training with competence assessment[1]. Addressing this training deficit is essential to improve surgical outcomes and meet the demand for hernia repairs across these populations.
Successful management of complicated burst abdomen with open abdomen using only simple saline dressing
(Wiley Online Library, 2025-03-25) Muganga, Dionizi; Basimbe, Francis; Nayiga, Irene; Ategeka, Amanda; Malinga, Paddy; Muwanga, Twaha
Necrosis of the rectus or lateral abdominal wall investing fascia may be associated with invasive infections or closure under extreme tension. This can lead to fascial dehiscence and evisceration of the intra-abdominal contents. Globally, abdominal wound dehiscence varies from 0.4% to 3.5% with associated mortalities reaching up to 45% in the perioperative period. Redo surgical operations and infectious complications are the major risk factors for abdominal wound dehiscence, but also presence of low albumin, glucocorticoid use, chest infections, and emergency surgeries have been also implicated. Open abdomen has been employed in incidences of trauma where a second look operation may be necessary, loss of abdominal wall, sepsis after penetrating abdominal trauma, and in cases of severe secondary peritonitis and acute pancreatitis. Patients with open abdomen are at a risk of fistula formation, sepsis, and loss of abdominal domain due to lateral fascial retraction. To reduce the mentioned complications mesh and nonmediated techniques to bridge fascia defects have been recommended with particular emphasis on biologic meshes with or without negative pressure wound therapy, component separation, or planned ventral hernia. We report a case of necrosis of the rectus and abdominal wound dehiscence and its management in a sub-Saharan setting, highlighting the challenges encountered and lessons learned. Retention sutures should be used cautiously in the management of wound dehiscence as it increases the risk of fascial necrosis in cases of intra-abdominal hypertension, as seen in our patient. In the absence of a VAC dressing, the utilization of routine saline gauze dressing promotes epithelialization over the exposed bowel and is a viable alternative to temporary abdominal closure modes of managing an open abdomen in a resource-limited setting.