Background: Gastroesophageal reflux disease (GERD) is a frequent clinical disorder characterized by the reflux of gastric constituents into the esophagus or oropharynx via lower esophageal sphincter (LES), leading to complications and/or injury to esophageal tissue fatal enough to disrupt a patient's life and necessitating long-term management with medicines and lifestyle changes. Aim of the work:To evaluate and contrasting the surgical results of a 270° wrap (Toupet, T) versus a 360° wrap (Nissen, N) in patients with gastroesophageal reflux disease (GERD) in accordance with symptom alleviation, therapeutic response, and postoperative complications like dysphagia, gas bloat disorder, and recurrence. Patients and methods: Laparoscopic antireflux surgery was performed on a sum of 20 individuals with extreme GERD and/or hiatal hernia. Participants were separated into two groups: group I underwent Nissen fundoplication, with ten patients, and group II underwent Toupet fundoplication, with ten patients. Age, gender, BMI, functional esophageal test before surgery, symptom alleviation, post-operative complications, and inpatient duration were all similar across the two groups.Results: Toupet fundoplication (TF) was related with considerably reduced postoperative dysphagia than Nissen fundoplication in patients with GERD and concurrent preoperative esophageal dysmotility (NF). Conclusion:The findings of this research show that laparoscopic fundoplication is a secure and effective management for GERD. Despite the fact that laparoscopic Nissen fundoplication is regarded the benchmark for anti-reflux surgeries, our research found that Toupet Fundoplication (TF) is linked with considerably reduced postoperative dysphagia in GERD patients than Nissen Fundoplication (NF).
Background: Sentinel lymph node biopsy is now a standard therapeutic approach for early-stage breast cancer. Arm lymphatic mapping, according to some researchers, is useful for identifying and preserving the arm lymphatics, and this novel process is referred to as "axillary reverse mapping" (ARM), since the arm lymphatics are being identified for preservation rather than eradication. Aim of the work:To study the feasibility of using sodium diethyl ammonium hydroxide (patent blue) dye to perform an axillary reverse mapping (ARM) procedure in breast cancer women with positive axillary lymph nodes. Patients and methods: This study included (40) patients. All patients were underwent surgery in general surgery and surgical oncology departments of Al-Azhar university hospitals. Inclusion criteria in study, patients who are histopathologically proved to have breast cancer, and patients with clinical and radiological positive axillary lymph nodes. Results: Our study findings; 20.0% were diabetic and 15.5% were hypertensive. 72.5% of studied group managed by MRM and 27.5% by CBS. Majority were below axillary vein 62.5% and lateral to thoracodorsal nerve 57.5% and we had 5 cases not detected regard stain. No case had anaphylaxis, 4 cases had infection, and 2 cases with ulceration and overall complicated cases were 6 (15.0%). Complicated cases significantly elder and higher regard weight and BMI also significantly associated with diabetes mellitus (DM). Conclusion: ARM can be done by using Sodium diethyl ammonium hydroxide (patent blue )dye With high rate of success and very low rate of complications .
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