Background: Papillary Thyroid Cancer (PTC) is the most common malignancy in thyroid gland and may be unifocal or multifocal. This study compares between unifocal and multifocal PTC to clarify which type has an aggressive behaviour.Methods: This retrospective and prospective cross-sectional study was done on one hundred PTC patients who underwent papillary thyroid cancer management. The unifocal and multifocal groups each one contains 50 patients. The study was done in the period between January 2015 to January 2018. Other types of cancer thyroid and distant metastatic thyroid cancer were excluded from the study. All patients underwent follow up for one year.Results: There are significant differences between unifocal and multifocal PTC regarding to age, the number of positive lymph nodes, history of multinodular goiter (MNG) and capsular invasion. The capsular invasion in multifocal increase the recurrence rate (P=0.03).Conclusions: The new proposed method for PTC tumor size assessment could be a valuable in multifocal PTC patient’s stratification into low risk and high-risk subgroups. Therefore, high risk multifocal PTC patients could have a poor prognosis and high rate of recurrence, for that require aggressive treatment and strict follow up.
Background: Intestinal anastomosis dates back to 1000, B.C but it accompanied with high rates of failure, sepsis, wound infection and mortality until the development of suture materials. Lembert described his seromuscular suture technique in 1826. Surgical Stapler was first introduced by Hultl in 1908. The development of modern devices over the past 30 years changes the surgical practice dramatically. The objective of present study is to compare the outcome between Stapler and handswen anastomosis in the small intestine.Methods: This study is a randome controlled study carried on 40 patients divided into two equal groups, 20 patients were treated by handswen suture method (group A) and the other 20 patients operated by stapling technique (group B).Results: In both elective and emergent cases as regard patient operative time, postoperative passing flatus, begin of oral intake, hospital stay duration and postoperative complications it was lower in Stapler (group B) comparing to handswen (group A) and P-value was statistically significant (P<0.05). In emergent cases postoperative leakage is equal in both handswen (group A) and Stapler (group B) and P-value was non-significant (P>0.05).Conclusions: In both elective and emergent cases the duration of operation, postoperative passing flatus, return of bowel sound, hospitalization days and postoperative complications including (intraoperative bleeding, prolonged ileus >4 days, patient stenosis and wound infection) in Stapler anastomosis it was lower comparing to handswen anastomosis and P-value was statistically significant (P<0.05). No significant difference in postoperative leakage between handswen anastomosis and Stapler anastomosis in emergency cases (P>0.05).
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