The management of a vestibular fistula is a challenge for pediatric surgeons. We compared four different operative techniques in terms of postoperative complications, continence, and cosmetic appearance. This prospective, randomized, comparative study included female children with rectovestibular fistulae who were selected from patients with Anorectal Malformations (ARMs) treated between January 2016 and July 2020. The patients were randomly divided into four groups based on the operative technique: Trans-Sphincter Anorectoplasty (TSARP), Posterior Sagittal Anorectoplasty (PSARP), Classic Anterior Sagittal Anorectoplasty (ASARP), and modified ASARP. The incidence of vestibular fistulae among all patients with ARMs was 13.4%. The total number of patients with vestibular fistula was 112, including eighty-four (75%) with rectovestibular fistulae and twenty-eight (25%) with anovestibular fistulae. Associated congenital anomalies were found in nineteen (22.6%) patients. The percentage of parents satisfied with the cosmetic appearance and continence of their children was the highest after TSARP. PSARP had the lowest incidence regarding vaginal wall injuries. TSARP is the best operative technique for handling rectovestibular fistulae and is suitable for infants and children. In the TSARP technique, the external sphincter muscle can be preserved following complete dissection of the rectum without the need for a midline skin incision. A midline skin incision is required in the modified ASARP technique.
Background: Hepatocellular carcinoma (HCC) is the most typical primary viscus malignancy and also the second leading reason behind cancer-related death worldwide. Objectives: To study the association between the tomography and pathological options of HCC for getting an honest designation on the lesions of HCC for getting the best treatment and prognosis of these lesions. Patients and Methods: Study of the imaging criteria of HCC which includes the arterial enhancement and venous washout in both CT and MRI within a background of cirrhosis, and it's a possible association with the vascular density and microvascular invasion seen in the biopsy. We enrolled consecutive cirrhotic patients with HCC liver resection in 2 years (from January 2018 till December 2019). Results: Our results on the number of lesions cleared that, the number of lesions ranged from 1 in number that observed in 68 (66.02 %) and 2 that observed in 11 (10.68 %), followed by 3, 4, and 5 lesions that observed in 1 (0.97 %) of the examined patients. The higher incidences of the lesions observed in middle hepatic vein 55 (53.40 %) right lobe of the liver 16 (15.54 %) , seg 2/3 10 (9.71 %), right liver 5 (4.86 %), left liver 5 (4.86 %) and in left lateral liver 4 (3.88 %).
Conclusion:The association between the Imaging and pathological features of HCC including microvascular invasion and density which is very important for getting an honest designation on the lesions of HCC and for getting the best treatment and prognosis of these lesions.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.