Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357103
Ahmed Ghanem, M. Amer, Waleed M Ghareeb
Background: One of the most frequent surgical emergencies in the world is acute appendicitis. In recent years, laparoscopic appendectomy has been the treatment of choice for adult patients because of its widespread acceptability. This study sought to assess the preoperative risk factors for conversion as well as the results of adult patients who had laparoscopic to open appendectomy conversion. Patients and Methods: This retrospective analysis involved 100 patients who underwent laparoscopic appendectomy and had a clinical diagnosis of acute appendicitis. Patients were all 18 years old and above. Patient demographics, comorbidities, preoperative laboratory results, computed tomography, and ultrasound findings, surgical time, intraoperative findings, need for conversion, duration of hospital stay, postoperative morbidity, and readmissions were all gathered for study. Results: Of the participants in our study, 11% had converted from a laparoscopic to an open approach. According to univariate logistic regression analysis, there were several significant risk factors for conversion, including intra-abdominal fluid, appendicular perforation, appendicular necrosis or gangrene, perithyphilitic abscess, peritonitis, high white blood cell (WBCs) count, high BMI, patients with high American Society of Anesthesiologists score, diabetes mellitus, and high C-reactive protein (CRP). Only high WBC count, high CRP, appendicular perforation, appendicular necrosis or gangrene, perithyphilitic abscess, and peritonitis were identified to be significant risk variables of conversion on multivariate logistic regression analysis. Conclusion: The laparoscopic method is an effective treatment for most patients with acute appendicitis. High preoperative WBC count and CRP levels, as well as radiographic abnormalities (perforation, necrosis or gangrene, perithyphilitic abscess, and peritonitis), were the preoperative independent risk factors for the requirement for conversion.
背景：急性阑尾炎是世界上最常见的外科急症之一。近年来，腹腔镜阑尾切除术因其广泛的可接受性而成为成年患者的首选治疗方法。本研究旨在评估从腹腔镜阑尾切除术转为开腹阑尾切除术的成年患者的术前风险因素以及术后效果。患者和方法：这项回顾性分析涉及 100 名接受腹腔镜阑尾切除术且临床诊断为急性阑尾炎的患者。患者年龄均在 18 岁及以上。研究收集了患者的人口统计学资料、合并症、术前化验结果、计算机断层扫描和超声波检查结果、手术时间、术中检查结果、是否需要转院、住院时间、术后发病率和再入院率。研究结果在我们的研究中，11%的参与者从腹腔镜手术转为开腹手术。单变量逻辑回归分析显示，腹腔积液、阑尾穿孔、阑尾坏死或坏疽、阑尾周围脓肿、腹膜炎、高白细胞计数、高体重指数（BMI）、美国麻醉医师协会评分高、糖尿病和高 C 反应蛋白（CRP）是导致患者转为开腹手术的几个重要风险因素。在多变量逻辑回归分析中，只有高白细胞计数、高 CRP、阑尾穿孔、阑尾坏死或坏疽、阑尾周围脓肿和腹膜炎被确定为转阴的重要风险变量。结论腹腔镜方法对大多数急性阑尾炎患者都是一种有效的治疗方法。术前白细胞计数和 CRP 水平较高以及影像学异常（穿孔、坏死或坏疽、脓肿和腹膜炎）是需要转院的术前独立风险因素。
{"title":"Identification of preoperative risk factors associated with the conversion of laparoscopic to open appendectomies","authors":"Ahmed Ghanem, M. Amer, Waleed M Ghareeb","doi":"10.21608/ejsur.2024.357103","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357103","url":null,"abstract":"Background: One of the most frequent surgical emergencies in the world is acute appendicitis. In recent years, laparoscopic appendectomy has been the treatment of choice for adult patients because of its widespread acceptability. This study sought to assess the preoperative risk factors for conversion as well as the results of adult patients who had laparoscopic to open appendectomy conversion. Patients and Methods: This retrospective analysis involved 100 patients who underwent laparoscopic appendectomy and had a clinical diagnosis of acute appendicitis. Patients were all 18 years old and above. Patient demographics, comorbidities, preoperative laboratory results, computed tomography, and ultrasound findings, surgical time, intraoperative findings, need for conversion, duration of hospital stay, postoperative morbidity, and readmissions were all gathered for study. Results: Of the participants in our study, 11% had converted from a laparoscopic to an open approach. According to univariate logistic regression analysis, there were several significant risk factors for conversion, including intra-abdominal fluid, appendicular perforation, appendicular necrosis or gangrene, perithyphilitic abscess, peritonitis, high white blood cell (WBCs) count, high BMI, patients with high American Society of Anesthesiologists score, diabetes mellitus, and high C-reactive protein (CRP). Only high WBC count, high CRP, appendicular perforation, appendicular necrosis or gangrene, perithyphilitic abscess, and peritonitis were identified to be significant risk variables of conversion on multivariate logistic regression analysis. Conclusion: The laparoscopic method is an effective treatment for most patients with acute appendicitis. High preoperative WBC count and CRP levels, as well as radiographic abnormalities (perforation, necrosis or gangrene, perithyphilitic abscess, and peritonitis), were the preoperative independent risk factors for the requirement for conversion.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"18 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357116
Mohamed M. El Fiky, Yasser M. El Nahas, Faisal A. Mourad, Ihab A. Ali, Hussein A. Z. Khalifa
Background: Between 40 and 60% of individuals following cardiac surgery report having postoperative right ventricular dysfunction (RVD), which is a manifestation of decreased septal function (paradoxical septal motion). Aim and objectives: To investigate the association between RVD and the outcome of cardiac surgery for mitral valve intervention including morbidity and mortality up to 3 months after surgery. Patients and Methods: A total of 47 patients were included in the prospective observational comparative evaluation, which was split into two groups, group 1 [high risk group tricuspid annular plane systolic excursion (TAPSE) less than 1.6] and group 2 (low risk group TAPSE more than 1.6). The study took place from August 2019 to August 2021 at the National Heart Institute (NHI) and the Cardiothoracic Surgery Department of Ain Shams University. Results: There were nonsignificant differences demonstrated between the groups in terms of age, gender, body mass index (BMI), mitral pathology, the duration of mechanical ventilation, ICU length of stay, the incidence of postoperative bleeding, the volume of postoperative bleeding, the composite endpoint of complications, the type of complication, or the lengths of ICU stay. The high-risk group’s TAPSE scores were found to be considerably lower at the 3-month evaluation ( P<0.001 ). Only two variables, preoperative TAPSE and cross-clamp time, were found to be statistically significant in predicting the risk of all-cause death, according to the findings of the multivariate regression analysis. Conclusion: RV dysfunction was detected by a thorough preoperative echocardiographic evaluation. Reducing surgical adverse events and mortality may be possible with the identification of preoperative RV dysfunction.
{"title":"Prognostic value of right ventricular dysfunction on clinical outcomes for patients undergoing surgical interventions for mitral valve","authors":"Mohamed M. El Fiky, Yasser M. El Nahas, Faisal A. Mourad, Ihab A. Ali, Hussein A. Z. Khalifa","doi":"10.21608/ejsur.2024.357116","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357116","url":null,"abstract":"Background: Between 40 and 60% of individuals following cardiac surgery report having postoperative right ventricular dysfunction (RVD), which is a manifestation of decreased septal function (paradoxical septal motion). Aim and objectives: To investigate the association between RVD and the outcome of cardiac surgery for mitral valve intervention including morbidity and mortality up to 3 months after surgery. Patients and Methods: A total of 47 patients were included in the prospective observational comparative evaluation, which was split into two groups, group 1 [high risk group tricuspid annular plane systolic excursion (TAPSE) less than 1.6] and group 2 (low risk group TAPSE more than 1.6). The study took place from August 2019 to August 2021 at the National Heart Institute (NHI) and the Cardiothoracic Surgery Department of Ain Shams University. Results: There were nonsignificant differences demonstrated between the groups in terms of age, gender, body mass index (BMI), mitral pathology, the duration of mechanical ventilation, ICU length of stay, the incidence of postoperative bleeding, the volume of postoperative bleeding, the composite endpoint of complications, the type of complication, or the lengths of ICU stay. The high-risk group’s TAPSE scores were found to be considerably lower at the 3-month evaluation ( P<0.001 ). Only two variables, preoperative TAPSE and cross-clamp time, were found to be statistically significant in predicting the risk of all-cause death, according to the findings of the multivariate regression analysis. Conclusion: RV dysfunction was detected by a thorough preoperative echocardiographic evaluation. Reducing surgical adverse events and mortality may be possible with the identification of preoperative RV dysfunction.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"26 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141711186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357137
Elsayed M. Abdelwahab, Heba T. Abdelaziz, Ahmed G.E. Metwally
Background: A hernia is characterized as a vesicle or portion of a vesicle protruding through an irregular gap in the walls of the cavity it is contained in. Of all the hernia types, inguinal hernias are the most prevalent. Aim & Objectives: To evaluate the duration of the procedure, discomfort after the procedure, length of hospital stay following the procedure, return to normal life, and recurrence of the hernia, two polypropylene mesh fixation techniques for inguinal hernia repair, as described by Lichtenstein, are being compared: fibrin glue and suture fixation. Patients and Methods: This prospective study was carried out in the Department of Surgery, El-Zhraa University Hospital, Al-Azhar University, from April 2021 to May 2023, on 80 patients who were divided into two groups: group A (40 cases used fibrin glue mesh fixation in open inguinal hernia repair) and group B (40 cases used suture mesh fixation in open inguinal hernia repair). Results: Regarding hospital stays and operating times, there was a notable distinction between the two groups: the prolene suture group’s operating time was longer than the fibrin glue group’s. When comparing the speed of return to normal life between the groups receiving fibrin glue and prolene suture, there was a statistically significant difference. Patients receiving fibrin glue returned to normal life more quickly than those receiving prolene suture. Conclusion: Fibrin glue is a safer and more acceptable option for mesh fixation than prolene suture in Liechtenstein hernioplasty procedures, but it comes at a hefty price.
{"title":"Fibrin glue versus sutures for mesh fixation in open repair of inguinal hernia","authors":"Elsayed M. Abdelwahab, Heba T. Abdelaziz, Ahmed G.E. Metwally","doi":"10.21608/ejsur.2024.357137","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357137","url":null,"abstract":"Background: A hernia is characterized as a vesicle or portion of a vesicle protruding through an irregular gap in the walls of the cavity it is contained in. Of all the hernia types, inguinal hernias are the most prevalent. Aim & Objectives: To evaluate the duration of the procedure, discomfort after the procedure, length of hospital stay following the procedure, return to normal life, and recurrence of the hernia, two polypropylene mesh fixation techniques for inguinal hernia repair, as described by Lichtenstein, are being compared: fibrin glue and suture fixation. Patients and Methods: This prospective study was carried out in the Department of Surgery, El-Zhraa University Hospital, Al-Azhar University, from April 2021 to May 2023, on 80 patients who were divided into two groups: group A (40 cases used fibrin glue mesh fixation in open inguinal hernia repair) and group B (40 cases used suture mesh fixation in open inguinal hernia repair). Results: Regarding hospital stays and operating times, there was a notable distinction between the two groups: the prolene suture group’s operating time was longer than the fibrin glue group’s. When comparing the speed of return to normal life between the groups receiving fibrin glue and prolene suture, there was a statistically significant difference. Patients receiving fibrin glue returned to normal life more quickly than those receiving prolene suture. Conclusion: Fibrin glue is a safer and more acceptable option for mesh fixation than prolene suture in Liechtenstein hernioplasty procedures, but it comes at a hefty price.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141688861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.275345.1017
Abanoub Magdy Abd El-Malak Ter Elbar, Reda S.M. Ezz, W. Gerges
.
.
{"title":"Evaluation of hemorrhoid laser procedure with anal suture mucopexy and its effectiveness to treat second and third-degree hemorrhoids: A prospective study","authors":"Abanoub Magdy Abd El-Malak Ter Elbar, Reda S.M. Ezz, W. Gerges","doi":"10.21608/ejsur.2024.275345.1017","DOIUrl":"https://doi.org/10.21608/ejsur.2024.275345.1017","url":null,"abstract":".","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"5 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141701303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357142
Souad E. M. Mansour, A. M. Abdel-Aziz, A. M. Osman, Suzan F. Ibrahim, Souad Elsayed, Mohammed Mansour
Background: Incidental extramammary findings on breast MRI may be lesions of medical importance, benign or metastatic lesions. Objective: Assessment of the added value of extending the field of view in MRI breast study for detection of extramammary findings and its impact on the diagnosis. Patients and Methods: A cross sectional study of 100 breast MRI s was conducted with extending the field of view from lower neck to upper abdominal levels. Results: 100 incidental findings were found in 69/100 (69%) examined patients. 10/100incidental findings (10%) were confirmed to be malignant while the remaining 90/100 (90%) benign. The most common site was the liver (38/69; 55.07%), followed by the bone (30/69; 43.47%), Heart (14/69; 20.28%), lung (5/69;7.24%) ,chest wall (5/69;7.24%), thyroid gland (3/69;4.34%), spleen (2/69;2.89%), left supraclavicular lymph nodes (1/69;1.44%), diaphragm (1/69;1.44%), gall bladder (1/69;1.44%). The incidence of incidental findings resulted to be high in that group of patients by extending the MRI field of view. MRI findings has high correct diagnosis with a high diagnostic accuracy value. Conclusion: Incidental extramammary findings on breast MRI are common. Benign lesions represent the most frequent findings, however malignant ones need to be searched especially in patients with personal history of breast cancer because they could influence the clinical patient management. Extending the field of view in breast MRI can characterize incidental findings with high accuracy value.
{"title":"The added value of extended field of view in breast MRI cancer patients","authors":"Souad E. M. Mansour, A. M. Abdel-Aziz, A. M. Osman, Suzan F. Ibrahim, Souad Elsayed, Mohammed Mansour","doi":"10.21608/ejsur.2024.357142","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357142","url":null,"abstract":"Background: Incidental extramammary findings on breast MRI may be lesions of medical importance, benign or metastatic lesions. Objective: Assessment of the added value of extending the field of view in MRI breast study for detection of extramammary findings and its impact on the diagnosis. Patients and Methods: A cross sectional study of 100 breast MRI s was conducted with extending the field of view from lower neck to upper abdominal levels. Results: 100 incidental findings were found in 69/100 (69%) examined patients. 10/100incidental findings (10%) were confirmed to be malignant while the remaining 90/100 (90%) benign. The most common site was the liver (38/69; 55.07%), followed by the bone (30/69; 43.47%), Heart (14/69; 20.28%), lung (5/69;7.24%) ,chest wall (5/69;7.24%), thyroid gland (3/69;4.34%), spleen (2/69;2.89%), left supraclavicular lymph nodes (1/69;1.44%), diaphragm (1/69;1.44%), gall bladder (1/69;1.44%). The incidence of incidental findings resulted to be high in that group of patients by extending the MRI field of view. MRI findings has high correct diagnosis with a high diagnostic accuracy value. Conclusion: Incidental extramammary findings on breast MRI are common. Benign lesions represent the most frequent findings, however malignant ones need to be searched especially in patients with personal history of breast cancer because they could influence the clinical patient management. Extending the field of view in breast MRI can characterize incidental findings with high accuracy value.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"27 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141712993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357147
Ahmed B. Soliman, Mohamed Al-Shubaki
Introduction: Constipation is a common problem among patients who are taking antipsychotic medication, there is a strong association between the use of risperidone and megacolon but the exact mechanism behind this has not established yet. Case Report: We present a case of megacolon associated with the long-term use of antipsychotic medication, this patient needs surgical intervention to resolve the problem. Discussion/Conclusion: Constipation and related complications represent a problem among psychotic patients who are taking antipsychotic medications, especially the older groups, more studies are needed to identify the exact relation that could be related to the disease itself or the use of a specific kind of medicine.
{"title":"Megacolon associated with the chronic use of antipsychotic medication","authors":"Ahmed B. Soliman, Mohamed Al-Shubaki","doi":"10.21608/ejsur.2024.357147","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357147","url":null,"abstract":"Introduction: Constipation is a common problem among patients who are taking antipsychotic medication, there is a strong association between the use of risperidone and megacolon but the exact mechanism behind this has not established yet. Case Report: We present a case of megacolon associated with the long-term use of antipsychotic medication, this patient needs surgical intervention to resolve the problem. Discussion/Conclusion: Constipation and related complications represent a problem among psychotic patients who are taking antipsychotic medications, especially the older groups, more studies are needed to identify the exact relation that could be related to the disease itself or the use of a specific kind of medicine.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"124 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.275037.1015
Kareem Kamel, Ahmad Mamdouh Kelany, Tarek Youssef Ahmed, Ahmed Aly Khalil
Background: Full-thickness rectal prolapse is a debilitating disease that is treated mainly surgically. Various abdominal and perineal procedures have been reported as a surgical treatment for rectal prolapse. Suture rectopexy by the laparoscopic approach has recently gained acceptance as a favored surgical technique for rectal prolapse treatment. This study aims to evaluate the short-term outcomes of laparoscopic suture rectopexy performed for full-thickness rectal prolapse (FTRP). Patients and Methods: This is a retrospective observational study evaluating laparoscopic suture rectopexy as regards postoperative recurrence, bowel function, constipation and incontinence, sexual function, and overall satisfaction in a 6-month duration after surgery. The study included 31 adult patients admitted at Ain-Shams University Hospitals with complete rectal prolapse operated by the same surgical team between January 2021 and December 2022. Results: Out of 31 patients who underwent laparoscopic suture rectopexy, one case only had a complete recurrence, no sexual disorders had been reported. Nineteen patients presented with constipation; seven of them had complete resolution, nine were significantly improved; however, three patients had no change. Eleven patients presented with incontinence, seven had complete resolution, and the other four were improved according to the Wexner score. Conclusion: For full-thickness rectal prolapse, laparoscopic suture rectopexy is a safe procedure with a low recurrence rate and good functional results during the short-term follow-up.
{"title":"Short-term outcomes of laparoscopic suture rectopexy in the treatment of full-thickness rectal prolapse","authors":"Kareem Kamel, Ahmad Mamdouh Kelany, Tarek Youssef Ahmed, Ahmed Aly Khalil","doi":"10.21608/ejsur.2024.275037.1015","DOIUrl":"https://doi.org/10.21608/ejsur.2024.275037.1015","url":null,"abstract":"Background: Full-thickness rectal prolapse is a debilitating disease that is treated mainly surgically. Various abdominal and perineal procedures have been reported as a surgical treatment for rectal prolapse. Suture rectopexy by the laparoscopic approach has recently gained acceptance as a favored surgical technique for rectal prolapse treatment. This study aims to evaluate the short-term outcomes of laparoscopic suture rectopexy performed for full-thickness rectal prolapse (FTRP). Patients and Methods: This is a retrospective observational study evaluating laparoscopic suture rectopexy as regards postoperative recurrence, bowel function, constipation and incontinence, sexual function, and overall satisfaction in a 6-month duration after surgery. The study included 31 adult patients admitted at Ain-Shams University Hospitals with complete rectal prolapse operated by the same surgical team between January 2021 and December 2022. Results: Out of 31 patients who underwent laparoscopic suture rectopexy, one case only had a complete recurrence, no sexual disorders had been reported. Nineteen patients presented with constipation; seven of them had complete resolution, nine were significantly improved; however, three patients had no change. Eleven patients presented with incontinence, seven had complete resolution, and the other four were improved according to the Wexner score. Conclusion: For full-thickness rectal prolapse, laparoscopic suture rectopexy is a safe procedure with a low recurrence rate and good functional results during the short-term follow-up.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"2 s2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141703310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357127
W. Hussen, Muhanned K. Ali, Ali H. Sayyid
. ABSTRACT Background: Solitary fibrous tumor of the pleura (SFTP), or pleural fibromas, are rare tumors that generally, but not universally, follow a benign course, though malignant changes may encountered. Their surgical resection is the standard treatment. Aim: Is to present six cases of SFTP, their age, sex, clinical presentation, imaging findings, operative appearances, the outcome of resection, histopathological results, and any encountered morbidity or mortality. Patients and Methods: Six patients with the SFTP were studied retrospectively. They were admitted, investigated, and operated upon during 3 years period from January 1 to 31, 2020. December 2022 in the thoracic department of the surgical specialties hospital of the Medical City Teaching Complex in Baghdad, Iraq. Surgical resection was the standard treatment for those patients. Results: Four of our patients were females. The remaining two were males. Their ages range between 35 and 80 years, with a mean age of 54.6. Computed tomography scan of the chest was done for all of them in addition to a tru-cut biopsy. Thoracotomy was offered for all of them, and complete surgical removal was done for five of them. Postoperative course was smooth, with wound infection encountered in two of them treated successfully and the early appearance of a new cutaneous mass in the sixth patient, for which resection was done under local anesthesia. Conclusion: Their early surgical resection offers the best chance of cure and may prevent their progression into malignant changes.
{"title":"Solitary fibrous tumor of the pleura","authors":"W. Hussen, Muhanned K. Ali, Ali H. Sayyid","doi":"10.21608/ejsur.2024.357127","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357127","url":null,"abstract":". ABSTRACT Background: Solitary fibrous tumor of the pleura (SFTP), or pleural fibromas, are rare tumors that generally, but not universally, follow a benign course, though malignant changes may encountered. Their surgical resection is the standard treatment. Aim: Is to present six cases of SFTP, their age, sex, clinical presentation, imaging findings, operative appearances, the outcome of resection, histopathological results, and any encountered morbidity or mortality. Patients and Methods: Six patients with the SFTP were studied retrospectively. They were admitted, investigated, and operated upon during 3 years period from January 1 to 31, 2020. December 2022 in the thoracic department of the surgical specialties hospital of the Medical City Teaching Complex in Baghdad, Iraq. Surgical resection was the standard treatment for those patients. Results: Four of our patients were females. The remaining two were males. Their ages range between 35 and 80 years, with a mean age of 54.6. Computed tomography scan of the chest was done for all of them in addition to a tru-cut biopsy. Thoracotomy was offered for all of them, and complete surgical removal was done for five of them. Postoperative course was smooth, with wound infection encountered in two of them treated successfully and the early appearance of a new cutaneous mass in the sixth patient, for which resection was done under local anesthesia. Conclusion: Their early surgical resection offers the best chance of cure and may prevent their progression into malignant changes.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"45 31","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357120
Mahmoud Abdelhameid, Mohamed Abdelshafy, A. Taha
. ABSTRACT Background: Component separation techniques are an integral step in the repair of incisional hernias with huge defects. Anterior component separation (ACS) and posterior component separation (PCS) with transversus abdominis muscle release (TAR) are commonly utilized. Aim: To compare ACS with onlay hernioplasty versus PCS-TAR with retrorectus hernioplasty to treat huge defect incisional hernias. Patients and Methods: This is a prospective comparative study on 35 patients who underwent surgical repair for midline incisional hernias with defects more than 10 cm in width. Patients were randomly allocated into two groups. Group A included patients for ACS with onlay hernioplasty, and group B included patients for PCS-TAR with retrorectus hernioplasty. Surgeries were performed under general anesthesia and patients’ follow-up was done for up to 1 year. Demographic, perioperative, and follow-up data were collected, tabulated, and analyzed by SPSS 26. Results: Group A included 18 patients, and group B included 17 patients. There is no statistically significant difference between the two groups regarding the preoperative variable. PCS-TAR had statistically significant longer operative time, fewer days of suction drainage, lower incidence of Surgical Site Infection (SSI) and seroma, and lower incidence of recurrence. Conclusion: In surgical repair of incisional hernias with huge defects, PCS-TAR had significantly lower wound morbidity and recurrence rates than the ACS.
{"title":"Component separation hernioplasty for huge defect midline incisional hernias, anterior versus posterior with transversus abdominis release: A prospective comparative study","authors":"Mahmoud Abdelhameid, Mohamed Abdelshafy, A. Taha","doi":"10.21608/ejsur.2024.357120","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357120","url":null,"abstract":". ABSTRACT Background: Component separation techniques are an integral step in the repair of incisional hernias with huge defects. Anterior component separation (ACS) and posterior component separation (PCS) with transversus abdominis muscle release (TAR) are commonly utilized. Aim: To compare ACS with onlay hernioplasty versus PCS-TAR with retrorectus hernioplasty to treat huge defect incisional hernias. Patients and Methods: This is a prospective comparative study on 35 patients who underwent surgical repair for midline incisional hernias with defects more than 10 cm in width. Patients were randomly allocated into two groups. Group A included patients for ACS with onlay hernioplasty, and group B included patients for PCS-TAR with retrorectus hernioplasty. Surgeries were performed under general anesthesia and patients’ follow-up was done for up to 1 year. Demographic, perioperative, and follow-up data were collected, tabulated, and analyzed by SPSS 26. Results: Group A included 18 patients, and group B included 17 patients. There is no statistically significant difference between the two groups regarding the preoperative variable. PCS-TAR had statistically significant longer operative time, fewer days of suction drainage, lower incidence of Surgical Site Infection (SSI) and seroma, and lower incidence of recurrence. Conclusion: In surgical repair of incisional hernias with huge defects, PCS-TAR had significantly lower wound morbidity and recurrence rates than the ACS.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"37 S1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357113
Ahmed M. Hanafy, Mohamed A. Nada, Essam F. Ebied, K. Kamel
Background: In the context of acute mesenteric ischemia (AMI), the extent of bowel resection poses a surgical complexity due to the potential exacerbation of mesenteric ischemia postsurgery. Consequently, employing damage-control surgery (DCS) alongside a subsequent second-look operation presents an opportunity to effectively address the critical state of the patient and evaluate bowel viability after resuscitative measures. Objectives: Evaluate the role of DCS in salvaging small bowel segments that were doubtful during the primary operation after resection of the necrotic bowel. Assess the role of DCS in overall morbidity and mortality. Patients and Methods: A prospective cohort study conducted at Ain-Shams University Hospitals. A total of 29 patients were admitted to our department with the diagnosis of AMI and underwent DCS. Twenty-two patients were hemodynamically unstable intraoperatively, and seven patients were stable. They were evaluated regarding saving bowel length from resection and overall morbidity and mortality. Results: A total of 29 patients underwent DCS for diffuse mesenteric ischemia with ill-defined margins for gangrenous bowel; all patients passed without stump blowout, and further resection of previously query ischemic segments done in 22 (75.9%) patients, saving bowel length from resection reaching up to 18 cm. Three (10.3%) patients had anastomotic leakage that has been managed conservatively; one of them had an enterocutaneous fistula that resolved over 6 weeks. Conclusion: The DCS strategy (abbreviated laparotomy) offers significant advantages and demonstrates commendable outcomes among patients with AMI with diffuse and indistinct margins. This approach notably contributes to preserving bowel length and reducing the overall morbidity and mortality rates
{"title":"Evaluation of damage-control surgery in cases of acute mesenteric ischemia for salvaging small bowel length","authors":"Ahmed M. Hanafy, Mohamed A. Nada, Essam F. Ebied, K. Kamel","doi":"10.21608/ejsur.2024.357113","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357113","url":null,"abstract":"Background: In the context of acute mesenteric ischemia (AMI), the extent of bowel resection poses a surgical complexity due to the potential exacerbation of mesenteric ischemia postsurgery. Consequently, employing damage-control surgery (DCS) alongside a subsequent second-look operation presents an opportunity to effectively address the critical state of the patient and evaluate bowel viability after resuscitative measures. Objectives: Evaluate the role of DCS in salvaging small bowel segments that were doubtful during the primary operation after resection of the necrotic bowel. Assess the role of DCS in overall morbidity and mortality. Patients and Methods: A prospective cohort study conducted at Ain-Shams University Hospitals. A total of 29 patients were admitted to our department with the diagnosis of AMI and underwent DCS. Twenty-two patients were hemodynamically unstable intraoperatively, and seven patients were stable. They were evaluated regarding saving bowel length from resection and overall morbidity and mortality. Results: A total of 29 patients underwent DCS for diffuse mesenteric ischemia with ill-defined margins for gangrenous bowel; all patients passed without stump blowout, and further resection of previously query ischemic segments done in 22 (75.9%) patients, saving bowel length from resection reaching up to 18 cm. Three (10.3%) patients had anastomotic leakage that has been managed conservatively; one of them had an enterocutaneous fistula that resolved over 6 weeks. Conclusion: The DCS strategy (abbreviated laparotomy) offers significant advantages and demonstrates commendable outcomes among patients with AMI with diffuse and indistinct margins. This approach notably contributes to preserving bowel length and reducing the overall morbidity and mortality rates","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"292 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141692256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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