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The outcomes of open colorectal anastomosis of side-to-end vs. end-to-end in non-emergent sigmoid and rectal cancer surgery in adults were compared. Methods: A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018. Results: The mean age was 62.58 ± 12.3 years in the side-to-end anastomotic (SEA) group and 61.03 ± 13.98 years in the endto-end anastomotic (EEA) group. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were significantly associated with leakage. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (P = 0.04). There is a statistically significant difference regarding incontinence for flatus in the SEA group only (P ≤ 0.001). A statistically significant change in both groups regards incontinence for liquid stools (P ≤ 0.001) and clustering of stools (P ≤ 0.001 and P = 0.043). The quality of life in the SEA group significantly dropped at 6 months and then returned to baseline as regards to physical well-being (PWB), functional well-being (FWB), and colorectal cancer symptoms (CCS) with no difference as regards SWB and EWB, while in the EEA group, the exact change happened only as regard PWB and FWB, but SWB and CCS percentage did not return to baseline. Conclusion: The SEA group offers a safe alternative approach to the EEA group.

Background: Fistula tract Laser closure (FiLaC) and Ligation of intersphincteric Fistula Tract (LIFT) are feasible and safe techniques with low postoperative pain and minimal incontinence. Objectives: Our study aimed to preserve the anal sphincter and decrease the rate of incontinence and recurrence of the fistula during the management of intersphincteric perianal fistula. Patients and Method: This was a prospective observational study for 6 months at Department of General Surgery, Zagazig University Hospitals. Two groups of 56 patients were formed. Group A underwent fistula tract laser closure and group B ligation of intersphincteric fistula tract. Patients were followed for 6 months for postoperative pain, recurrence, and complication. Results: In our analysis, the average operating time was 19.3 minutes (min), while in the LIFT group it was 48.6 min with a statistically significantly higher mean operation time in the LIFT group. The mean hospital stay time postoperatively in the FiLac group was 8.1 hours, which was significantly lower than in the LIFT group (17.1 hours). In the FiLaC group, the mean time of healing was 16.4 days while in LIFT the mean healing time was 32 days, which was statistically higher than the FilaC group. Postoperative pain was statistically wrose in the LIFT group than the FiLaC group. There was no substantial difference between the two groups after a considerable period of follow-up. Conclusion: Our research found that both approaches are promising techniques, with higher healing rates and a lower risk of incontinence or recurrence after surgery. However, LIFT was quite significantly better for healing rate and recurrence, while fistula tract laser closure was slightly significantly better for postoperative pain and incontinence.

Background: The best surgical method for hemorrhoidectomy is still unknown; hence innovative procedures like harmonic scalpel hemorrhoidectomy and stapled hemorrhoidectomy need to be researched. Objective: The aim of this work was the selection of best method of treatment of third and fourth degree primary haemorrhoids.Patients and methods: The present clinical trial included 36 patients with the diagnosis of symptomatic 3rd and 4th degree primary hemorrhoids, admitted to the Department of General Surgery, Zagazig University Hospitals for surgical management. The patients were divided equally into Group 1 who underwent Stapled hemorrhoidopexy, and Group 2 who underwent harmonic scalpel hemorrhoidectomy. All patients in both groups were followed up weekly for the first 4 postoperative weeks. Postoperative pain, fecal incontinence, time of complete healing, and early recurrence were evaluated. Results: Postoperative pain was less in the Stapler group with significantly difference from the harmonic group. Fecal incontinence was higher in harmonic group but with no statistically significant difference from Stapler group. Healing and return work were significantly higher among Stapler group with no significant difference from harmonic group. Regarding early recurrence, Stapler group had two cases, while harmonic group had only one case with no statistically significant difference between both groups. Conclusion: Stapled hemorrhoidopexy had better results than harmonic scalpel hemorrhoidectomy because it was associated with less postoperative pain, less fecal incontinence and less incidence of wound complications.

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Purpose The outcomes of open side-to-end colorectal anastomosis versus open end to end colorectal anastomosis in non-emergent sigmoid and rectal cancers open surgery in adults were compared. Methods A randomized controlled trial on individuals with sigmoid and rectal cancers was conducted between September 2016 and September 2018. Results The majority of the participants in the study were between the ages of 50 and 70 years, with a mean age of 62.58±12.3 years in the side-to-end anastomotic group (SEA group = group A = antegrade approach) and 61.03±13.98 years in the end-to-end anastomotic group (EEA group = group B = retrograde approach), respectively. Except for the operative time, intraoperative data revealed no significant differences between the studied groups, and the SEA group revealed that the mean anastomotic time was significantly shorter. Perioperative blood loss, length of stay, reoperation, inpatient death, infection, and bleeding were all revealed to be significantly associated with leakage in univariate analysis. In a multivariate analysis of anastomotic leaks, infection was the only independent predictor. There is a statistically significant change regarding the range of bowel frequency in the EEA group only (p = 0.04). There is a statistically significant difference regarding incontinence for Flatus in the SEA group only (p = 0.00). A statistically significant change in both groups regards incontinence for liquid stools (p = 0.00) and clustering of stools (p = 0.00 and p = 0.043). The quality of life (QOL) in the SEA group significantly dropped at 6 months and returned to baseline after that as regards PWB, FWB, and CCS with no difference as regards SWB & EWB, while in the EEA group, the exact change happened only as regard PWB & FWB, but SWB and CCS percentage did not return to baseline. Conclusion The SEA group offers a safe and approach alternative to the EEA group.