No abstract

These findings indicate that one-stage transanal endorectal pull-through operation in adolescent and adults is feasible and safe.

Highlights Conjoined twins are a subset of monozygotic twin gestation. They are classified according to the most prominent site of conjunction. Surgical separation of conjoined twins is extremely challenging and high risk. Our reported omphalopagus had no associated anomalies. The presence of associated malformations is unrelated to the site of union.

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.

Objectives: Assessment of angiogenic activity through evaluation of Vascular endothelial growth factor concentration and determination of endothelial cells percentage in the peripheral blood of patients with Chronic myeloid leukemia compared to healthy subjects in order to investigate their role in the pathogenesis and for early detection of the disease progression. Subjects and Methods: Twenty patients with Chronic myeloid leukemia and 15 healthy controls were studied. Evaluation of Vascular endothelial growth factor level in serum was measured by enzyme-linked immunosorbent assay. Determination of circulating endothelial cells percentage expressing CD133 and/or CD34 by flow cytometry in the peripheral blood was also done. Results: The level of Vascular endothelial growth factor was significantly elevated in all groups when compared to controls (p=<0.001). A significant increase of endothelial cells was observed in Chronic myeloid leukemia patients with blast crisis phase compared to other phases (p=<0.001). In patients with chronic phase and accelerated phase the number of endothelial cells was slightly increased compared to the control group but the differences were not statistically significant. Conclusion: The level of Vascular endothelial growth factor was highly elevated in all phases of Chronic myeloid leukemia. While the flow cytometric evaluation of endothelial cell surface markers in the blood of Chronic myeloid leukemia patients can identify a subset of patients with a more aggressive disease course.