BACKGROUND: Many studies have shown that open and laparoscopicsurgery for resection of colonic cancers produce similar short- and long-term results, but no data have been reported from Saudi Arabia.OBJECTIVE: Compare 3-year disease-free and overall survival after laparoscopic versus open curative resection for potentially curable colon cancer.DESIGN: Multicenter retrospective cohort study.SETTING: Tertiary academic hospital.PATIENTS AND METHODS: We analyzed data of patients who underwent curative resection for potentially curable colon cancer using the laparoscopic or open approach at three tertiary care centers during the period 2000-2015.MAIN OUTCOME MEASURES: Overall and disease-free 3-year survival were the primary endpoints. Secondary endpoints included conversion rate, duration of surgery, length of hospital stay, rate of wound infection, resumption of bowel function, number of lymph nodes retrieved, adequacy of resection and rate of recurrence. Risk factors for recurrence, including complete mesocolic excision, were assessed.SAMPLE SIZE: 721.RESULTS: Patient and tumor characteristics were similar in the two groups except for ASA class (P<.01), weight (P<.05) and tumor stage (P<.05). Over a median follow-up of 46 months, the 3-year overall survival was 76.7% for open resection and 90.3% for laparoscopic colon resection (P<.05). The 3-year disease-free survival was 55.3% for open colon resection and 64.9% for laparoscopic colon resection (P=.0714).CONCLUSION: Overall and disease-free survival after the laparoscopic approach for curative resection of colon cancer is comparable to the open approach.LIMITATIONS: Retrospective design and the possibility of selection bias.CONFLICT OF INTEREST: None.

Objectives: To examine the predictors of pediatric ventriculoperitoneal)VP(shunt malfunction in a university hospital. Methods: A retrospective cohort was conducted. Patients under 18 years old who underwent VP shunt revision at least once between 2016 and 2019 were included. Data were stratified based on age, gender, diagnosis, type of valve, valve position, cause of revision, and part revised. Results: A total of 45 patients)64% males and 36% females(were included in this study. Eighty-two revision surgeries were identified. The most common revised part was the entire shunt system. The most Original Article common type of valve which required revision was the low-pressure valve)15.5%(. Since a p-value of less than 0.05 was considered significant, no significant differences among the 4 groups for different points. Conclusions: Younger age at initial VP shunt insertion is associated with a higher rate of shunt malfunction. Valve mechanical failures followed by infections are the most common causes for the first 3 revisions. A prospective multi-center study to confirm the current findings is recommended.

BACKGROUND: The accessory navicular bone (ANB) is one of the most common accessory bones in the foot. Certain pathologies, such as posterior tibial tendon insufficiency are associated with ANB, and should be differentiated from midfoot and hindfoot fractures such as navicular tuberosity avulsion fractures. There are few studies addressing the prevalence and types of ANB in Saudi Arabia. OBJECTIVES: Determine the prevalence and morphological variations of ANB and its relation with age and sex in patients visiting foot and ankle clinics. DESIGN: Medical record review SETTING: Orthopedic foot and ankle clinic at a university hospital. PATIENTS AND METHODS: The presence of ANB was retrospectively analyzed in radiographs from patients who presented to the orthopedic foot and ankle at our university hospital from February 2010 to December 2020. The patients were stratified according to sex, age, and diagnosis. For each ANB, recorded information included site, size, classification, subtypes, and symptomatology. Purposive sampling was used to select the patients for the study (non-probability sampling). MAIN OUTCOME MEASURES: Prevalence of ANB in patients attending a foot and ankle clinic. SAMPLE SIZE: 117 patients and 194 feet. RESULTS: ANB was analyzed in 1006 radiographs from 503 patients. ANB was detected in 117 (23.3%) patients and 194 (19.3%) feet Prevalence was significantly higher in females (67.5%) than in males (32.5%) (Z=5.359, P <.001). The ages ranged from 19 to 86 years, with a mean age of 48.26 (14.5) years. The most common site was bilateral (77 patients, 65.8 %). Type I was the most common type, with a prevalence of 42.1%. There were no significant differences in types in relation to sex, but all types and subtypes differed significantly from each other. CONCLUSION: ANB was common among patients presenting to the foot and ankle clinic, with an overall prevalence of 23.3%. It should be considered among the differential diagnosis in chronic foot pain, and should be differentiated from midfoot and hindfoot fractures. Further studies with a larger, randomized sample are needed, for more accuracy and to confirm the reported results. LIMITATIONS: Retrospective chart review, non-probability sampling, and use of plain radiographs. CONFLICT OF INTEREST: None.

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