Pub Date : 2024-07-01DOI: 10.21608/ejsur.2024.357128
Ahmed Aly Khalil, Kareem Gamal, Tarek Yousef, Mohamed Gouda, Kareem Kamel
Background: Laparoscopic right colectomy is a widely accepted surgical technique for colon cancer resection, commonly using either intracorporeal anastomosis (ICA) or extracorporeal anastomosis (ECA). Our study compares the benefits of ICA versus ECA, as ICA has been suggested to provide faster recovery and shorter hospital stays. However, there is a lack of scientific evidence in this regard. Patients and Methods: An randomized clinical trial was conducted from November 2021 to June 2023 to compare intraoperative technical events and short-term postoperative clinical outcomes. Results: A total of 71 were randomized. The median operative time for the ECA group was 226.67 min (range: 167–310) and 222.78 min for the ICA group (range: 158–263) with no significant difference between them ( P=0.606 ). There is no significant difference in the number of harvested lymph nodes between the ECA group (mean: 13.88, range: 12–15) and the ICA group (mean: 13.78, range: 12–16) ( P=0.664 ). The incidence of postoperative ileus, vomiting, and intestinal obstruction did not differ significantly between the two groups ( P=0.728 , 0.795, and 0.885, respectively). Significantly, there was a higher incidence of wound infection in the ECA group ( P=0.047 ). The ICA group had significantly lower pain scale scores on the postoperative day ( P<0.001 ). Significantly shorter mean length of postoperative hospital stays was seen in the ICA group (4.15 vs. 5.27 for ECA, P<0.001 ). Delayed postoperative complications showed no significant difference ( P=0.061 and 0.362 for incisional hernia and internal hernia, respectively). Conclusion: ICA has less postoperative pain, shorter time to first flatus, shorter length of hospital stays, and lower rates of wound infection with nearly the same operative time compared with ECA.
{"title":"Short-term outcomes of intracorporeal versus extracorporeal ileotransverse anastomosis in laparoscopic right colectomy: A prospective randomized study","authors":"Ahmed Aly Khalil, Kareem Gamal, Tarek Yousef, Mohamed Gouda, Kareem Kamel","doi":"10.21608/ejsur.2024.357128","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357128","url":null,"abstract":"Background: Laparoscopic right colectomy is a widely accepted surgical technique for colon cancer resection, commonly using either intracorporeal anastomosis (ICA) or extracorporeal anastomosis (ECA). Our study compares the benefits of ICA versus ECA, as ICA has been suggested to provide faster recovery and shorter hospital stays. However, there is a lack of scientific evidence in this regard. Patients and Methods: An randomized clinical trial was conducted from November 2021 to June 2023 to compare intraoperative technical events and short-term postoperative clinical outcomes. Results: A total of 71 were randomized. The median operative time for the ECA group was 226.67 min (range: 167–310) and 222.78 min for the ICA group (range: 158–263) with no significant difference between them ( P=0.606 ). There is no significant difference in the number of harvested lymph nodes between the ECA group (mean: 13.88, range: 12–15) and the ICA group (mean: 13.78, range: 12–16) ( P=0.664 ). The incidence of postoperative ileus, vomiting, and intestinal obstruction did not differ significantly between the two groups ( P=0.728 , 0.795, and 0.885, respectively). Significantly, there was a higher incidence of wound infection in the ECA group ( P=0.047 ). The ICA group had significantly lower pain scale scores on the postoperative day ( P<0.001 ). Significantly shorter mean length of postoperative hospital stays was seen in the ICA group (4.15 vs. 5.27 for ECA, P<0.001 ). Delayed postoperative complications showed no significant difference ( P=0.061 and 0.362 for incisional hernia and internal hernia, respectively). Conclusion: ICA has less postoperative pain, shorter time to first flatus, shorter length of hospital stays, and lower rates of wound infection with nearly the same operative time compared with ECA.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"43 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698067","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.2024.357106
Yahya Kamal
Target: The goal of the study was to compare the outcomes of two different approaches to treating hand and wrist ganglia: the lay-open procedure and typical surgical excision. Patients and Methods: This study was conducted at the surgery department of the Alqureen General Hospital in Sharkia, Egypt, between January and December of 2023. This survey was completed by 40 individuals who had wrist or hand ganglions. Patients were divided into two categories based on casual distribution. Traditional surgical excision was used to treat one kind (group A), whereas a lay-open technique was used to treat the other kind (group B). Recurrences were noted during the 6-month proceedings for both. Results: The typical surgical excision took much longer to complete (61.2 vs. 23.7 min; P<0.001 ) than the lay-open procedure. There was a considerable variance between the two sorts with relation to the operating maneuver complexity ( P<0.001 ). Group A experienced more satisfied postoperative complications. However, when it came to wound infection and the appearance of minor postoperative discomfort, the difference between the two types was not statistically significant ( P=0.3 ). Patients in type B reported higher levels of satisfaction (90 vs. 45%; P<0.001 ). Conclusion: When compared with typical surgical excision for the treatment of hand and wrist ganglion cysts, the lay-open procedure appears to be preferable.
{"title":"Comparative research for surgical excision and lay-open maneuver in treatment of hand and wrist ganglion cyst","authors":"Yahya Kamal","doi":"10.21608/ejsur.2024.357106","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357106","url":null,"abstract":"Target: The goal of the study was to compare the outcomes of two different approaches to treating hand and wrist ganglia: the lay-open procedure and typical surgical excision. Patients and Methods: This study was conducted at the surgery department of the Alqureen General Hospital in Sharkia, Egypt, between January and December of 2023. This survey was completed by 40 individuals who had wrist or hand ganglions. Patients were divided into two categories based on casual distribution. Traditional surgical excision was used to treat one kind (group A), whereas a lay-open technique was used to treat the other kind (group B). Recurrences were noted during the 6-month proceedings for both. Results: The typical surgical excision took much longer to complete (61.2 vs. 23.7 min; P<0.001 ) than the lay-open procedure. There was a considerable variance between the two sorts with relation to the operating maneuver complexity ( P<0.001 ). Group A experienced more satisfied postoperative complications. However, when it came to wound infection and the appearance of minor postoperative discomfort, the difference between the two types was not statistically significant ( P=0.3 ). Patients in type B reported higher levels of satisfaction (90 vs. 45%; P<0.001 ). Conclusion: When compared with typical surgical excision for the treatment of hand and wrist ganglion cysts, the lay-open procedure appears to be preferable.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706229","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.2024.357119
Hosam B. Barakat, Ahmed Badran, Mohamed Elsheikh
Background: Despite the increasing prevalence of obesity among elderly individuals, there is ongoing debate regarding the safety of bariatric procedures in this age group. Objective: This study aimed to assess the efficacy and safety of laparoscopic sleeve gastrectomy (LSG), specifically in patients aged 55 years and older. Patients and Methods: A retrospective analysis was performed on patients subjected to LSG in our institution from 2019 to 2023. Forty elderly patients more than or equal to 55 years were included (study group) and were matched with forty younger patients (control group) based on BMI, sex, and comorbidities distribution. The study compared short-term outcomes regarding weight loss, comorbidities improvement, operative time, hospital stay, and complications. Results: There were no significant differences regarding the demographic characteristics or preoperative comorbidities distribution within the two groups. The mean operative time was slightly longer in the older patients than in the control group (53.85±12.17 vs. 49.25±16.22 min, respectively), but with no statistical significance. There was no perioperative mortality in both groups. The percent excess weight loss at 1 year for the older group was significantly lower than that for the younger group (58.1 vs. 68.74%. respectively). Most comorbidities in both groups were improved or resolved with no significant statistical. The morbidity rate was 15 and 17.5% for the elderly and the younger group, respectively, with no significant difference. Conclusion: LSG is safe and effective in patients more than or equal to 55 years and presents a valuable bariatric option that is efficient in inducing weight loss and improving obesity-related comorbidities and is associated with an acceptable morbidity rate comparable to younger populations.
{"title":"Safety and efficacy of laparoscopic sleeve gastrectomy in elderly patients: A matched case-control study","authors":"Hosam B. Barakat, Ahmed Badran, Mohamed Elsheikh","doi":"10.21608/ejsur.2024.357119","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357119","url":null,"abstract":"Background: Despite the increasing prevalence of obesity among elderly individuals, there is ongoing debate regarding the safety of bariatric procedures in this age group. Objective: This study aimed to assess the efficacy and safety of laparoscopic sleeve gastrectomy (LSG), specifically in patients aged 55 years and older. Patients and Methods: A retrospective analysis was performed on patients subjected to LSG in our institution from 2019 to 2023. Forty elderly patients more than or equal to 55 years were included (study group) and were matched with forty younger patients (control group) based on BMI, sex, and comorbidities distribution. The study compared short-term outcomes regarding weight loss, comorbidities improvement, operative time, hospital stay, and complications. Results: There were no significant differences regarding the demographic characteristics or preoperative comorbidities distribution within the two groups. The mean operative time was slightly longer in the older patients than in the control group (53.85±12.17 vs. 49.25±16.22 min, respectively), but with no statistical significance. There was no perioperative mortality in both groups. The percent excess weight loss at 1 year for the older group was significantly lower than that for the younger group (58.1 vs. 68.74%. respectively). Most comorbidities in both groups were improved or resolved with no significant statistical. The morbidity rate was 15 and 17.5% for the elderly and the younger group, respectively, with no significant difference. Conclusion: LSG is safe and effective in patients more than or equal to 55 years and presents a valuable bariatric option that is efficient in inducing weight loss and improving obesity-related comorbidities and is associated with an acceptable morbidity rate comparable to younger populations.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"73 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714740","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.2024.274273.1008
Muhammad Musalam, Amr Abdel Nasser, Amro Abdelaal, Ahmed Khalil, H. S. Saber
Background: Portal vein thrombosis (PVT) is a relative contraindication in living donor liver transplantation (LDLT). We monitored the outcome of adult patients with PVT in comparison to patients without PVT in LDLT.. Methods: This study is a retrospective cohort study. LDLTs that were performed at Liver Transplantation Unit in Air Forces Hospital and Nasser Institute, between January 2016 and June 2022 were evaluated. 176 cases were divided into two groups according to the presence of PVT, group A included 55 recipients who had PVT compared with group B including 121 recipients without PVT.. Results: In our study (N = 176), postoperative PV complications was recorded in 11 (6.3 %) cases. Five case in each group had postoperative PVT (9.8 % vs. 4.1 %), respectively and a single case of PV stenosis (0.8 %) was documented in non-PVT group. All patients who develop early postoperative PV (n = 3/10) complications unfortunately died because of it, unlike those who developed late PV complications, their 1 year survival rate was 70 % of cases and the overall mortality rate in patients developed PV complications was 40 %. Conclusion: PVT is established not to be a contraindication for LT but needs complex procedures and sophisticated techniques and Surgeons should be aware of these techniques to restore adequate portal flow in transplant for recipients with PVT.
{"title":"Comparative study for the outcome of living donor liver transplantation in patients with portal vein thrombosis in comparison to patients without portal vein thrombosi","authors":"Muhammad Musalam, Amr Abdel Nasser, Amro Abdelaal, Ahmed Khalil, H. S. Saber","doi":"10.21608/ejsur.2024.274273.1008","DOIUrl":"https://doi.org/10.21608/ejsur.2024.274273.1008","url":null,"abstract":"Background: Portal vein thrombosis (PVT) is a relative contraindication in living donor liver transplantation (LDLT). We monitored the outcome of adult patients with PVT in comparison to patients without PVT in LDLT.. Methods: This study is a retrospective cohort study. LDLTs that were performed at Liver Transplantation Unit in Air Forces Hospital and Nasser Institute, between January 2016 and June 2022 were evaluated. 176 cases were divided into two groups according to the presence of PVT, group A included 55 recipients who had PVT compared with group B including 121 recipients without PVT.. Results: In our study (N = 176), postoperative PV complications was recorded in 11 (6.3 %) cases. Five case in each group had postoperative PVT (9.8 % vs. 4.1 %), respectively and a single case of PV stenosis (0.8 %) was documented in non-PVT group. All patients who develop early postoperative PV (n = 3/10) complications unfortunately died because of it, unlike those who developed late PV complications, their 1 year survival rate was 70 % of cases and the overall mortality rate in patients developed PV complications was 40 %. Conclusion: PVT is established not to be a contraindication for LT but needs complex procedures and sophisticated techniques and Surgeons should be aware of these techniques to restore adequate portal flow in transplant for recipients with PVT.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"1 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696689","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.2024.357107
Ahmed F. Elkased, Naser M Abdel Bary, Mohamed S. Amar, Sherif Y. Hassan, Galal M. Abdel Kawy, Mohamed H. Elmelegy
. ABSTRACT Background: The current standard of care for locally advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. Recent research has highlighted the possible advantages of induction chemotherapy before concurrent Chemoradiotherapy (CRT) for individuals with locally advanced rectal cancer (LARC). Our research assesses the efficacy and viability of induction chemotherapy before concomitant chemoradiotherapy for locally advanced rectal cancer. Patients and Methods: Forty patients with locally advanced cancer rectum were enrolled in our study in 2019–2021. Initially, they underwent an induction chemotherapy regimen consisting of 3 cycles of FOLFOX (oxaliplatin, leucovorin, 5 fluorouracil) over 3 months. Response assessment of the patients was done by pelvic MRI. Concurrent chemoradiotherapy was given 2 weeks after completion of induction chemotherapy. Four weeks later, the patients were reassessed by pelvic MRI, computed tomography chest, and abdomen. Total mesorectal excision was performed at 6–8 weeks after the end of radiotherapy. Included patients were evaluated for pCR, Circumferential resection margins (CRM), RO resection, sphincter preservation, treatment toxicity, and postoperative morbidity and mortality. Results: In this study, sphincter preservation was achieved in eight out of 21 (38%) patients with low rectal tumors less than or equal to 5 cm who were candidates for Abdominoperineal resection (APR) and shifted to Anterior resection (AR); complete pathological response was achieved in seven (20.5%) patient; R0 resection was achieved in 34 (92%) patients; CRM was positive in three patients; two of them developed local recurrence and one of them developed distant metastasis. Conclusion: For locally
{"title":"Evaluation of the role of neoadjuvant chemotherapy in the management of rectal cancer","authors":"Ahmed F. Elkased, Naser M Abdel Bary, Mohamed S. Amar, Sherif Y. Hassan, Galal M. Abdel Kawy, Mohamed H. Elmelegy","doi":"10.21608/ejsur.2024.357107","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357107","url":null,"abstract":". ABSTRACT Background: The current standard of care for locally advanced rectal cancer is neoadjuvant chemoradiotherapy followed by surgery. Recent research has highlighted the possible advantages of induction chemotherapy before concurrent Chemoradiotherapy (CRT) for individuals with locally advanced rectal cancer (LARC). Our research assesses the efficacy and viability of induction chemotherapy before concomitant chemoradiotherapy for locally advanced rectal cancer. Patients and Methods: Forty patients with locally advanced cancer rectum were enrolled in our study in 2019–2021. Initially, they underwent an induction chemotherapy regimen consisting of 3 cycles of FOLFOX (oxaliplatin, leucovorin, 5 fluorouracil) over 3 months. Response assessment of the patients was done by pelvic MRI. Concurrent chemoradiotherapy was given 2 weeks after completion of induction chemotherapy. Four weeks later, the patients were reassessed by pelvic MRI, computed tomography chest, and abdomen. Total mesorectal excision was performed at 6–8 weeks after the end of radiotherapy. Included patients were evaluated for pCR, Circumferential resection margins (CRM), RO resection, sphincter preservation, treatment toxicity, and postoperative morbidity and mortality. Results: In this study, sphincter preservation was achieved in eight out of 21 (38%) patients with low rectal tumors less than or equal to 5 cm who were candidates for Abdominoperineal resection (APR) and shifted to Anterior resection (AR); complete pathological response was achieved in seven (20.5%) patient; R0 resection was achieved in 34 (92%) patients; CRM was positive in three patients; two of them developed local recurrence and one of them developed distant metastasis. Conclusion: For locally","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141706355","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.2024.273846.1001
S. Saber, Tarek M. Sehsah, Mahmoud A. Eissa
Background: Revisional bariatric surgeries for weight regain are rising; however, they are considered as riskier and less efficient than primary bariatric procedures. This study aimed to study short-term postoperative outcomes after Roux-en-Y gastric bypass (RYGB) for revision after failed Sleeve gastrectomy versus primary RYGB in Bariatric patients regarding Weight loss, comorbidity resolution, Postoperative complications, hospital stay, mortality, and readmissions. Patients and Methods: This retrospective study was designed to compare early postoperative outcome between 2 groups of patients admitted to General Surgery Department, Tanta University Hospitals during the period from June 2018 and June 2023. Results: A total of 254 patients were included in the study, with 87 patients in revisional RYGB and 167 patients in primary RYGB. Groups were matched for age, sex, smoking, preoperative weight, and comorbidities. The duration of revisional RYGB was significantly longer than primary RYGB (201.1±49.85 vs. 161.9±45.05; P <0.001 ). Revisional RYGB patients stayed longer in the hospital (2.54±0.74 vs. 1.87±0.78; P <0.001 ). Total weight loss was significantly higher after 6 months and 1 year in Primary RYGB than group revisional RYGB ( P value<0.05 ). However, no differences were detected in postoperative complications, readmissions, reoperation rates, and comorbidity resolution. Conclusion: RYGB as revisional surgery after a previous Sleeve gastrectomy is a complex procedure that must be indicated with care. It is a safe technique, with postoperative complication rates similar to those of primary RYGB, while it may need longer operative
{"title":"Short-term outcome after Roux-en-Y gastric bypass for revision after failed sleeve gastrectomy versus De novo Roux-en-Y gastric bypass for bariatric patients","authors":"S. Saber, Tarek M. Sehsah, Mahmoud A. Eissa","doi":"10.21608/ejsur.2024.273846.1001","DOIUrl":"https://doi.org/10.21608/ejsur.2024.273846.1001","url":null,"abstract":"Background: Revisional bariatric surgeries for weight regain are rising; however, they are considered as riskier and less efficient than primary bariatric procedures. This study aimed to study short-term postoperative outcomes after Roux-en-Y gastric bypass (RYGB) for revision after failed Sleeve gastrectomy versus primary RYGB in Bariatric patients regarding Weight loss, comorbidity resolution, Postoperative complications, hospital stay, mortality, and readmissions. Patients and Methods: This retrospective study was designed to compare early postoperative outcome between 2 groups of patients admitted to General Surgery Department, Tanta University Hospitals during the period from June 2018 and June 2023. Results: A total of 254 patients were included in the study, with 87 patients in revisional RYGB and 167 patients in primary RYGB. Groups were matched for age, sex, smoking, preoperative weight, and comorbidities. The duration of revisional RYGB was significantly longer than primary RYGB (201.1±49.85 vs. 161.9±45.05; P <0.001 ). Revisional RYGB patients stayed longer in the hospital (2.54±0.74 vs. 1.87±0.78; P <0.001 ). Total weight loss was significantly higher after 6 months and 1 year in Primary RYGB than group revisional RYGB ( P value<0.05 ). However, no differences were detected in postoperative complications, readmissions, reoperation rates, and comorbidity resolution. Conclusion: RYGB as revisional surgery after a previous Sleeve gastrectomy is a complex procedure that must be indicated with care. It is a safe technique, with postoperative complication rates similar to those of primary RYGB, while it may need longer operative","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"115 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141713174","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.2024.357126
M. Mohamed, Mohamed M. Mahmoud, Mohamed A. AbdElhady
Background: In Egypt, open Lichtenstein mesh repair is the standard management option for symptomatic unilateral inguinal hernia. The use of drains is routinely done by many surgeons after such procedures with no proven evidence of their benefits and complications. That motivated us to conduct the present study to evaluate the value of drain insertion in such patients. Patients and Methods: The data of 60 consecutive patients (30 patients in the drain group and another 30 patients in the drainless group) diagnosed with unliteral inguinal hernia and underwent open Lichtenstein hernioplasty were retrospectively reviewed. The main outcome was the incidence of postoperative adverse events, mainly seroma, hematoma, and wound infection. Results: Our analysis revealed no notable differences between the drain and drainless groups regarding patient and hernia characteristics. The operative time and hospitalization period were also statistically comparable. The incidence of postoperative complications did not show noteworthy differences between the two approaches. The incidence of wound infection was similar in both groups (3.3%). Seroma occurred in only one (3.3%) patient in the drainless group. Hematoma occurred in 3.3% of drain cases and 6.7% of drainless cases. Moreover, wound edema was encountered in 6.7 and 13.3% of cases in the same groups, respectively. No patients developed recurrence during the 1-year follow-up period. Conclusion: The use of drains is not associated with significant protective effects against posthernioplasty complications. Its use should be individualized to decrease the impact of drain-associated complications.
{"title":"Value of drain in reduction of seroma and wound infection in Lichtenstein repair of inguinal hernia","authors":"M. Mohamed, Mohamed M. Mahmoud, Mohamed A. AbdElhady","doi":"10.21608/ejsur.2024.357126","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357126","url":null,"abstract":"Background: In Egypt, open Lichtenstein mesh repair is the standard management option for symptomatic unilateral inguinal hernia. The use of drains is routinely done by many surgeons after such procedures with no proven evidence of their benefits and complications. That motivated us to conduct the present study to evaluate the value of drain insertion in such patients. Patients and Methods: The data of 60 consecutive patients (30 patients in the drain group and another 30 patients in the drainless group) diagnosed with unliteral inguinal hernia and underwent open Lichtenstein hernioplasty were retrospectively reviewed. The main outcome was the incidence of postoperative adverse events, mainly seroma, hematoma, and wound infection. Results: Our analysis revealed no notable differences between the drain and drainless groups regarding patient and hernia characteristics. The operative time and hospitalization period were also statistically comparable. The incidence of postoperative complications did not show noteworthy differences between the two approaches. The incidence of wound infection was similar in both groups (3.3%). Seroma occurred in only one (3.3%) patient in the drainless group. Hematoma occurred in 3.3% of drain cases and 6.7% of drainless cases. Moreover, wound edema was encountered in 6.7 and 13.3% of cases in the same groups, respectively. No patients developed recurrence during the 1-year follow-up period. Conclusion: The use of drains is not associated with significant protective effects against posthernioplasty complications. Its use should be individualized to decrease the impact of drain-associated complications.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141715819","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.2024.357141
Mohamed Salah El-din, Hesham Adel Alaa, Ayman Hossam Eldin, Ahmed Saeed Saad
Background: Thyroid auto transplantation was introduced after the success of parathyroid auto transplantation. Heterotopic thyroid autotransplantation is a technique that preserves viable thyroid tissue in the body after total thyroidectomy, which may revascularize and restore thyroid function. Thyroid autotransplantation can help avoid lifetime thyroid hormone replacement therapy, which may have some drawbacks such as disruption of lipid metabolism, coronary heart disease, non-compliance, and malabsorptionThyroid autotransplantation can also preserve the inner auto-regulatory mechanism of thyroid hormone production, which can adjust to the body’s needsThyroid autotransplantation can prevent reoperation at the site of previous neck surgery in cases of recurrent goiters or hyperthyroidism, which can be associated with a high rate of complications. heterotopic thyroid autotransplantation is still not a popular technique and there is limited data on its long-term outcomes and safety. Some studies have reported satisfactory results in terms of survival and function of the thyroid implant, but the number of patients and the follow-up periods were very low. There are also some challenges and controversies regarding the optimal site, size, and number of the grafts, as well as the indications and contraindications of this procedure.
{"title":"Trial of thyroid auto-transplantation after total thyroidectomy in benign thyroid diseases","authors":"Mohamed Salah El-din, Hesham Adel Alaa, Ayman Hossam Eldin, Ahmed Saeed Saad","doi":"10.21608/ejsur.2024.357141","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357141","url":null,"abstract":"Background: Thyroid auto transplantation was introduced after the success of parathyroid auto transplantation. Heterotopic thyroid autotransplantation is a technique that preserves viable thyroid tissue in the body after total thyroidectomy, which may revascularize and restore thyroid function. Thyroid autotransplantation can help avoid lifetime thyroid hormone replacement therapy, which may have some drawbacks such as disruption of lipid metabolism, coronary heart disease, non-compliance, and malabsorptionThyroid autotransplantation can also preserve the inner auto-regulatory mechanism of thyroid hormone production, which can adjust to the body’s needsThyroid autotransplantation can prevent reoperation at the site of previous neck surgery in cases of recurrent goiters or hyperthyroidism, which can be associated with a high rate of complications. heterotopic thyroid autotransplantation is still not a popular technique and there is limited data on its long-term outcomes and safety. Some studies have reported satisfactory results in terms of survival and function of the thyroid implant, but the number of patients and the follow-up periods were very low. There are also some challenges and controversies regarding the optimal site, size, and number of the grafts, as well as the indications and contraindications of this procedure.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"33 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141709205","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.2024.274248.1006
Mohamed Mahmoud Ezzat, Mohamed Adel Mohamed, Yasser Baz, Gehad Ahmed, Manal M. El Mahdy
. ABSTRACT Background: Breast cancer is the most commonly diagnosed cancer in women. Breast-conserving surgery is a common standard for treating many breast cancer patients. However, MRM (Modified radical mastectomy) is still done in ⁓ 30 % of patients undergoing surgeries. Our goal of the study is to identify factors that predict histopathological retro-areolar ducts and skin lymphatics tumor involvement, as well as to formulate bases extending the indication of skin sparing, especially nipple–areola complex (NAC) sparing mastectomy. Patients and Methods: The study is an observational analytic study conducted on 145 cases. Inclusion criteria of the study are females sex, aged more than 18 years with locoregional breast disease who are candidates for MRM. Exclusion criteria are cases with grossly involved NAC, inflammatory breast cancer, skin ulceration, and nodules, Paget’s disease of the nipple, and candidates for conservative breast surgery. Preoperatively, all patients were subjected to a triple assessment of the breast cancer. Postoperatively, all mastectomy specimens are sent for the histopathological assessment. Results: By univariate analysis, factors significantly affecting skin and NAC tumor involvement were age, tumor size, multifocality, nodal metastasis, histological grade, localized skin edema (peau d’orange), and lymphovascular invasion. By multivariate analysis, factors significantly increasing skin and NAC tumor involvement were nodal metastasis, localized skin edema, unexposure to neoadjuvant chemotherapy, and HER2 neo positive cases. Conclusion: We can extend indications of SSM (Skin sparing mastectomy) in cases with negative nodal metastasis and absence of localized skin edema, who were exposed to neoadjuvant chemotherapy and HER2 neo negative cases.
{"title":"Correlating preoperative clinicopathological factors with skin and/ or nipple–areola complex tumor involvement in postmastectomy specimens","authors":"Mohamed Mahmoud Ezzat, Mohamed Adel Mohamed, Yasser Baz, Gehad Ahmed, Manal M. El Mahdy","doi":"10.21608/ejsur.2024.274248.1006","DOIUrl":"https://doi.org/10.21608/ejsur.2024.274248.1006","url":null,"abstract":". ABSTRACT Background: Breast cancer is the most commonly diagnosed cancer in women. Breast-conserving surgery is a common standard for treating many breast cancer patients. However, MRM (Modified radical mastectomy) is still done in ⁓ 30 % of patients undergoing surgeries. Our goal of the study is to identify factors that predict histopathological retro-areolar ducts and skin lymphatics tumor involvement, as well as to formulate bases extending the indication of skin sparing, especially nipple–areola complex (NAC) sparing mastectomy. Patients and Methods: The study is an observational analytic study conducted on 145 cases. Inclusion criteria of the study are females sex, aged more than 18 years with locoregional breast disease who are candidates for MRM. Exclusion criteria are cases with grossly involved NAC, inflammatory breast cancer, skin ulceration, and nodules, Paget’s disease of the nipple, and candidates for conservative breast surgery. Preoperatively, all patients were subjected to a triple assessment of the breast cancer. Postoperatively, all mastectomy specimens are sent for the histopathological assessment. Results: By univariate analysis, factors significantly affecting skin and NAC tumor involvement were age, tumor size, multifocality, nodal metastasis, histological grade, localized skin edema (peau d’orange), and lymphovascular invasion. By multivariate analysis, factors significantly increasing skin and NAC tumor involvement were nodal metastasis, localized skin edema, unexposure to neoadjuvant chemotherapy, and HER2 neo positive cases. Conclusion: We can extend indications of SSM (Skin sparing mastectomy) in cases with negative nodal metastasis and absence of localized skin edema, who were exposed to neoadjuvant chemotherapy and HER2 neo negative cases.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"36 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141690415","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.2024.357125
Emad M. Abdelrahman, Sherif M. ElKaffas, Mohamed I. Abuelnasr
. ABSTRACT Background: In colorectal surgery, one of the trickiest techniques is the Hartmann reversal. The rate of anastomosis leaking varies. Minimally invasive surgeries like laparoscopic Hartmann reversal (LHR) have become more popular because of lower morbidities. The aim of this study was to report our institutional experience in LHR. Patients and Methods: The current prospective randomized study included 62 patients who were eligible for HR. Patients were randomly allocated into two equal groups. Group A (n=31) underwent LHR, while group B underwent open Hartmann reversal. Follow-up was planned for at least 6 months. Results: The mean age was 45.72±15.12 and 42.66±14.91 in groups A and B, respectively. There was a statistically significant longer mean operative time with more mean blood loss in group B ( P≤0.001 ) with a significantly longer hospital stay. The postoperative complications, including wound infection, dehiscence, seroma, intestinal leak, ileus, and incisional hernia, were evident in group B when compared to group A ( P≤0.001 ). Conclusion: Well-chosen patient makes (HR) a safe and beneficial technique for improving a patient’s quality of life. Patients can get substantial benefits with minimally invasive procedures, such as a quicker recovery with fewer operating hours, less projected blood loss, a shorter time to flatus, less pain following surgery, and a shorter hospital stay.
.摘要 背景：在结直肠手术中，哈特曼翻转术是最棘手的技术之一。吻合口的渗漏率各不相同。腹腔镜哈特曼逆转术（LHR）等微创手术因发病率较低而越来越受欢迎。本研究旨在报告本院在 LHR 方面的经验。患者和方法：本前瞻性随机研究包括 62 名符合 HR 条件的患者。患者被随机分配为两组。A 组（31 人）接受 LHR，B 组接受开放哈特曼逆转术。计划随访至少 6 个月。结果A 组和 B 组的平均年龄分别为（45.72±15.12）岁和（42.66±14.91）岁。B组平均手术时间更长，平均失血量更多，差异有统计学意义（P≤0.001），住院时间明显更长。与 A 组相比，B 组的术后并发症包括伤口感染、裂开、血清肿、肠漏、回肠炎和切口疝更为明显（P≤0.001）。结论为患者精心选择的微创手术（HR）是一项安全、有益的技术，可提高患者的生活质量。患者可从微创手术中获益良多，如手术时间更短，恢复更快，预计失血量更少，排便时间更短，术后疼痛更轻，住院时间更短。
{"title":"Laparoscopic Hartmann reversal: A single center experience in a developing country","authors":"Emad M. Abdelrahman, Sherif M. ElKaffas, Mohamed I. Abuelnasr","doi":"10.21608/ejsur.2024.357125","DOIUrl":"https://doi.org/10.21608/ejsur.2024.357125","url":null,"abstract":". ABSTRACT Background: In colorectal surgery, one of the trickiest techniques is the Hartmann reversal. The rate of anastomosis leaking varies. Minimally invasive surgeries like laparoscopic Hartmann reversal (LHR) have become more popular because of lower morbidities. The aim of this study was to report our institutional experience in LHR. Patients and Methods: The current prospective randomized study included 62 patients who were eligible for HR. Patients were randomly allocated into two equal groups. Group A (n=31) underwent LHR, while group B underwent open Hartmann reversal. Follow-up was planned for at least 6 months. Results: The mean age was 45.72±15.12 and 42.66±14.91 in groups A and B, respectively. There was a statistically significant longer mean operative time with more mean blood loss in group B ( P≤0.001 ) with a significantly longer hospital stay. The postoperative complications, including wound infection, dehiscence, seroma, intestinal leak, ileus, and incisional hernia, were evident in group B when compared to group A ( P≤0.001 ). Conclusion: Well-chosen patient makes (HR) a safe and beneficial technique for improving a patient’s quality of life. Patients can get substantial benefits with minimally invasive procedures, such as a quicker recovery with fewer operating hours, less projected blood loss, a shorter time to flatus, less pain following surgery, and a shorter hospital stay.","PeriodicalId":22550,"journal":{"name":"The Egyptian Journal of Surgery","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704440","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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