Background Undescended testis or cryptorchidism is one of the most common congenital abnormalities of the genitourinary system in young boys, approximately 1-2% of boys at the age of 1 year have undescended testis, the disorder being unilateral in about 90% of cases and bilateral in about 10%. Aim of the Work We conducted this prospective study to assess the efficacy and safety of single-incision, transscrotal orchidopexy in children with palpable UDT. Patients and Methods A prospective study was adopted to fulfill the purpose of the study. The study was conducted at Pediatric Surgery Department, Ain Shams University Hospitals in Cairo. The included study population was pediatric patients with palpable, inguinal mal-descended testes who attend to Pediatric Surgery Outpatient Clinic, Ain Shams University Hospital till the fulfillment of the sample size. Results The most common sites of undescended testis were intracanalicular and scrotal neck regions. The most common postoperative complication was scrotal edema. Mean operating time was 21 minutes. There was no significant difference in the testicular size pre and post operative. Conclusion Based on these results, we concluded that the undescended testis represents a common pediatric problem requiring surgical intervention. Trans-scrotal orchidopexy is an effective, less invasive and highly acceptable cosmetically approach for the treatment of palpable undescended testis.
Background. Superior mesenteric artery (SMA) syndrome is a rare disorder that may be managed surgically if conservative management fails. Different surgical techniques have been described, division of the ligament of Treitz, gastrojejunostomy, and duodenojejunostomy. The aim of this case series is to show that laparoscopic duodenojejunostomy is a safe and technically feasible management for superior mesenteric artery syndrome. Methods. In this case series, we retrospectively identified all patients who underwent laparoscopic duodenojejunostomy for SMA syndrome in our tertiary university center between December 2016 and July 2019. Data collected included demographics, presenting symptoms, comorbidities, pre and postoperative body mass index (BMI), operative approach, operative blood loss, operative duration, clinical and radiological results, in hospital/30-day complications, mortality, and postoperative follow-up outcomes. Results. We identified eleven patients, 10 females and 1 male, with a median age 23 years (range 17–43 years). All patients had refractory symptoms after a minimum of two months of conservative management and subsequently underwent laparoscopic duodenojejunostomy. There were no intraoperative complications and no in-hospital or 30-day postoperative mortality or complications were identified. Follow-up data showed complete resolution in 73% of patients (n = 8) and only one patient with no improvement postoperatively. Results also showed a median BMI increase of 2 kg/m2 (range 1–9 kg/m2) at a median follow-up of 16 months (range 4–48 months). Conclusion. Laparoscopic duodenojejunostomy is a safe treatment option for SMA syndrome and should be considered when patients do not respond to conservative management.
Background The normal thyroid gland is caudal to the larynx and encircles the anterolateral portion of the trachea. It is about 10 to 20 grams in weight in normal adults. Aim of the Work The aim of this study is to characterize the morbidity and complications of neck dissection in thyroid malignancy. Patients and Methods The present study will include 20 patients with thyroid cancer. All patients will undergo total thyroidectomy plus neck dissection. Neck dissection procedure was performed unilaterally in 16 patients (80%), and bilaterally in 4 (20%), making a total of 24 ND procedures. Results There were fifteen females (75%) and five males (52%), their age ranged between 26 and 70 years with a mean of 50 years. All patients were subjected to thorough history taking, complete clinical examination and vocal cord assessment by indirect laryngoscopy. Laboratory investigations (T3, T4, TSH, serum Ca, and routine laboratory work up), followed by neck ultrasonography (US), and computed tomography (CT) were performed for all patients, as well as chest X-ray, and CT chest when needed. Biopsy from suspicious thyroid lesion and suspicious cervical LNs (whether blind or US guided) was performed. Conclusion Morbidity and complications of neck dissection are numerous and variable so meticulous dissection is needed.
Background: The surgical technique of sleeve gastrectomy has not been fully standardized and, therefore, there are issues to be solved. Resection of the antrum is one of these debatable issues. Aim:The study aims at assessing the difference in long and short term weight loss between both antral resection laparoscopic sleeve gastrectomy & antral preservation laparoscopic sleeve gastrectomy.Patients and methods: Is a prospective randomized control study including 100 patients with BMI exceeding 35, fifty of them will undergo antral preservation in laparoscopic sleeve gastrectomy (group A), and the other fifty patients will undergo antral resection in laparoscopic sleeve gastrectomy (group B).Results: Weight loss and BMI reduction after 6 months in the antral resection group were more than the antral preservation group with mean weight 92.25 kg in antral resection group compared to 99.46 kg in antral preservation group and mean BMI 34.48 in antral resection group compared to 39.29 in antral preservation group. Also weight loss and BMI reduction after 12 months in the antral resection group were more than the antral preservation group with mean weight 71.60 kg in antral resection group compared to 77.20 kg in antral preservation group and mean BMI 26.41 in antral resection group compared to 30.71 in antral preservation group. Conclusion:Antral resection in LSG safely potentiates the restrictive effect achieved and may result in greater and better maintained weight loss.
Aims Superior Mesenteric Artery (SMA) Syndrome is a rare disorder which may be managed surgically when conservative management fails. We present a case series of six patients who underwent laparoscopic duodenojejunostomy in our tertiary centre for treatment of SMA Syndrome. The aim of our case series is to assess and present our outcomes in comparison to the limited available literature on the topic. Methods Retrospectively, we identified all patients who underwent laparoscopic duodenojejunostomy for SMA Syndrome in our tertiary university centre’s surgical database between December 2016 and July 2019. Data collected included demographics, presenting symptoms, co-morbidities, pre and post-operative Body Mass Index (BMI), operative approach, operative blood loss, operative duration, length of hospital stay, clinical and radiological results, in hospital/30 day complications, mortality and post operative follow up outcomes. Results We identified six patients, 1:5 male to female ratio, with a median age 18 years of age (range 17-31 years). All patients had refractory symptoms after a minimum of two months (range 2-5 months) of conservative management and subsequently underwent laparoscopic duodenojejunostomy. Median hospital stay was 7 days and no in hospital/30 day post operative mortality or complications were identified. Follow up data showed no recurrence of symptoms and a BMI median increase of 10.2 (range 8-13.6) at a median follow-up of 18 months (range 12-30 months) Conclusions Laparoscopic duodenojejunostomy is a safe treatment option for SMA syndrome and should be considered when patients do not respond to conservative management.
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