Thoracoscopy in a country with limited resources in sub-Saharan Africa: a first series of cases from Togo

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Lamboni Damessane Kondoh Bignandi Barnabo Nampoukine Kan-paatib, MD Alassani Tarek Issa-Toure A Adjoh Komi Adabra Komlan Tchangaï Katanga Boyodi


Objectives: Video-assisted thoracoscopic surgery is experiencing significant growth nowadays. However, in Africa, it is slow to develop. The objectives of this study were to describe the indications and results of thoracoscopy in low and incomes country as Togo.

Materials and Methods: A retrospective descriptive cross-sectional study was conducted on patients who underwent exploration and therapeutic procedures by video-assisted surgery from June 2019 to November 2020 and from January 2022 to September 2023 (39 months) in Lomé.

Results: Sixteen patients underwent thoracoscopy during the study period. The mean age was 46.06 +/- 23 years. Patients over 45 years old represented 56.2%. The male-to-female ratio was 2.2. Six patients underwent preoperative pleural biopsies. Videothoracoscopy was diagnostic in 10 patients and therapeutic in 6 patients. It was performed under general anesthesia with or without selective intubation in the majority of cases (14/16). Two ports were used in the majority of cases (8/16). Biopsies were performed in 11 patients and intraoperative pleural talc pleurodesis in 4 patients. Pleural debridement was performed in 2 patients. Conversion to thoracotomy was done in 5 patients. The average drainage duration was 4 days. The average length of hospital stay was 5 days. Morbidity and mortality were marked by one case of bronchopleural fistula.

Conclusion: Video-assisted thoracoscopic surgery is in its early stages in Togo. Preliminary results are encouraging for its development in Togo.

Keywords: Videothoracoscopy, Togo

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DAMESSANE, Lamboni et al. Thoracoscopy in a country with limited resources in sub-Saharan Africa: a first series of cases from Togo. Medical Research Archives, [S.l.], v. 12, n. 5, may 2024. ISSN 2375-1924. Available at: <>. Date accessed: 19 june 2024. doi:
Research Articles


1. Renaud S, Olland A, Falcoz P ; ReeB J, Santelmo N, Massard G. Chirurgie thoracique vidéo assistée dans le cancer bronchique non à petites cellules. Revue des Maladies Respiratoires 2015; 7 (4): 346 – 352.

2. Falase BA, Majekodunmi AA, Ismail S, Sanusi MO, Adeyeye OO. Video‑assisted thoracic surgery in a Nigerian teaching hospital: Experience and challenges. Nigerian Journal of Clinical Practice 2016 ; 19 (2) : 233 – 236.

3. Diatta S, Bagué Ah, Sow N F, Diop M S, Diagne P A, Ba P O, Arroye F, Dieng P A, Ndiaye A, Dem A, Ciss A G. Etude préliminaire de la symphyse pleurale par vidéo-thoracoscopie dans les pleurésies néoplasiques à Dakar. 2021; 6 (3): 156 – 163.

4. Schewitz I. Afr J Thoracic Crit Care Med 2018; 24 (1): 15 – 18.

5. Lamboni D, Bignandi K, Adambounou T.A, Akpanahè M, Assenouwe S, Aziagbe A, Alassani1 T, Tougan E, Adjoh K, Abalo A. Résections pulmonaires pour séquelles de tuberculose : résultats préliminaires à propos de huit cas opérés à Lomé – Togo. Rev Pneumol Trop 2020 ; 34 : 27-32

6. Geraldo RF, Tchangai B, Alassani F, Adabra K, Amouzou E-G, Koutora B, Dakey L, Dosseh E. Etat des lieux de la laparoscopie au Togo : plateau technique et indications. Journal Africain de Chirurgie Digestive 2020; 20 (1): 3002 – 3007.

7. Smith A, Ramnarine I, Pinkney P. Evolution of Video Assisted Thoracoscopic Surgery in the Caribbean. International Journal of Surgery. 2019 ; 72 : 19 – 22.

8. Marwane L, Sani R, Jamal G, Ibrahim I, Yassine O, Mohamed S. La place de la thoracoscopie dans la prise en charge des pathologies thoraciques : à propos de 104 cas. The Pan African Medical Journal. 2015; 21:42 doi:10.11604/pamj.2015.21.42.

9. Loddenkemper R, Noppen M, Mathur PN, Lee P. Medical thoracoscopy/pleuroscopy – Manual and Atlas. Stuttgart : Thieme Verlag, 2010.

10. Rudondy PH., Bergeron P., Wang Y., Husseini R. Chirurgie thoracique vidéo-assistée avec mini-thoracotomie ; limites et indications. Ann. chir. : chir. thorac. cardio. vasc., 1995, 49, 9, 831 – 834.

11. Jabri H, Afif H, Touzani I et al. Apport de la thoracoscopie dans le diagnostic des pleurésies excudatives. Rev Mal Respir. 2013 ; 30(1) : A1 - A192. PubMed | Google Scholar.

12. Kard El, Zaghba N, Benjelloun H et al. Les pleurésies sérofibrineuses. Rev Mal Respir. 2012 ; 29(1) : A1- A230. PubMed | Google Scholar.

13. Hadjer N, Kheloui Y, Nacef L et al. Apport de la thoracoscopie médicale dans le diagnostic étiologique et la prise en charge des pleurésies exsudatives récidivantes. Rev Mal Respir. 2009; 26 (1): 5 – 169. PubMed | Google Scholar.

14. Kolschmann S, Ballin A, Gillissen A. Clinical Efficacy and Safety of thoracoscopic talc Pleurodesis in malignant Pleural effusions. Chest 2005 ; 128 : 1431 – 35.

15. Barbetakis N, Asteriou C, Papadopoulou F, Samanidis G,et al. Early and late morbidity and mortality and life expectancy following thoracoscopic talc insufflations for control of malignant pleural effusions: a review of 400 cases. Journal of Cardiothoracic Surgery 2010, 5: 27.

16. Kirby T.J., Mack M.J., Landreneau R.J., Rice T.W. Lobectomy--video-assisted thoracic surgery versus muscle-sparing thoracotomy. A randomized trial J. Thorac. Cardiovasc. Surg. 1995; 109: 997 – 1002. [cross-ref].

17. Shigemura N., Akashi A., Nakagiri T., Ohta M., Matsuda H. Complete versus assisted thoracoscopic approach: a prospective randomized trial comparing a variety of video-assisted thoracoscopic lobectomy techniques Surg. Endosc. 2004; 18: 1492 – 1497. [cross-ref].

18. Morimoto T, Fukui T, Koyama H, Noguchi Y, Shimbo T. Optimal strategy for the first episode of primary spontaneous pneumothorax in young men. J Gen Intern Med 2002; 17: 193-202.

19. Munavvar M, Khan MA, Edwards J, et al: The autoclavable semi-rigid thoracoscope: the way forward in pleural disease? Eur Respir J 2007; 29: 571 – 574.

20. Sasada S, Kawahara K, Kusunoki Y, Okamoto N, Iwasaki T, Suzuki H, Kobayashi M, Hirashima T, Matsui K, Ohta M, Miyazawa T: A new electrocautery pleural biopsy technique using an insulated-tip diathermic knife during semirigid pleuroscopy. Surg Endosc 2009; 23: 1901 – 1907.

21. Shaw P, Agarwal R. Pleurodesis for malignant pleural effusions. Cochrane Database Syst Rev 2004, CD002916.