Background: Surgical site-infection (SSI) is common in abdominal wall wounds at site of stoma take-down, especially in obese patients. The aim of the study is to compare the proposed "Volcano" technique with the classical primary closure in obese patients as regards the incidence of SSI and short-term cosmetic outcome after one month.Patients and method: 20 "Obese" patients with diverting fecal stomas, whose stoma aperture was closed using the "volcano" technique, were compared to the last 20 matched patients, whose stoma aperture was closed using the primary closure technique, from the database as regards the incidence of SSI and the short-term cosmetic outcome of the postoperative wound.Results: One case of SSI was noticed in the study group in comparison to3 cases in the control group. The resulted scar in the study group was smaller and more cosmetically appealing. Conclusion:The "Volcano" technique is feasible with better outcome for cases of stoma reversal.
Background:The breast is a cornerstone image of femininity, and the heart of womanhood, as nourisher and comforter. The term "oncoplastic surgery" (OPS) refers to more than only the fusion of plastic and oncologic concepts. Surgeons can do wider excisions with free margins by modifying the residual breast tissue using different mammoplastic techniques, which lowers the incidence of re-excision. Objective: To assess and evaluate wide local excision technique as an oncoplastic procedure for management of breast carcinoma in the upper/upper lateral quadrant with matrix rotation technique regarding cosmetic, surgical outcomes, and patient satisfaction Patients and Methods: This prospective randomized controlled study included 30 patients with cancer breast scheduled for oncology breast surgery. They were divided to two equal groups: Group I: wide local excision technique. Group II: matrix rotation technique. Results: When testing the postoperative outcomes for all included patients, we found that 63.3% of patients had good cosmetic outcome postoperatively. 16.7% of patients had very good cosmetic outcome. Concerning patients' point of view, 80% of patients (24 patients) were totally satisfied about their postoperative outcome. 63.3% of them (19 patients) thought they had equal breast sizes while 36.7% of them (11 patients) thought they had a better breast shape as shown in table 3. Conclusion: Wide local excision is a safe oncoplastic technique, causing significantly less post-operative hematoma, mild seroma, minimal blood loss, less areolar deviation and better breast symmetry than matrix rotation technique.
Background: The round block technique (RBT) is an oncoplastic technique used in the excision of peri-areolar breast lesions especially in small to medium-sized breasts with moderate ptosis. Objective: Our study aims to introduce the technique of modified round block technique (MRBT) and to compare RBT and MRBT in peripherally located tumors as regards the oncological safety and cosmetic outcomes. Patients and methods: From October 2018 to October 2021, a randomized controlled clinical trial was conducted on 40 female patients with early stages of breast cancer. Patients selected had tumors at least 2 cm away from the nippleareola complex (NAC) and an expected excision volume not exceeding 20% of the breast volume. Patients' demographic data and tumor characteristics were recorded and analyzed. Results: The MRBT group has a significantly shorter operative time (P-value 0.016). Positive margin involvement was recorded in 2 cases requiring re-excision in the RBT group. Six patients developed seroma formation which was significantly higher in the MRBT group (P-value 0.048). A significantly lower mean change in areolar diameter was observed in the MRBT group (P-value 0.032). Two cases developed local recurrence, one in each group. No cases of distant metastasis were encountered during the follow-up. MRBT group has a significantly higher cosmetic outcome than RBT (P-value 0.03). Conclusion: The MRBT is an oncoplastic technique suitable for the excision of breast tumors in different breast quadrants especially peripherally located tumors in patients with small to medium-sized breasts and when the excision volume is not exceeding 20% of the breast volume.
Introduction:The incorporation of oncoplastic surgery techniques in the management of breast cancer became more popular and offers both oncological safety and good cosmetic results. It is highly challenging for surgeons to obtain good oncological control and acceptable cosmetic results, especially in tumors in the lower quadrant of the breast. The utility of anterior Intercostal Artery perforator flap (AICAP) in immediate reconstruction following breast-conserving surgery (BCS) is rarely described in the literature. In our study, we present our experience with the Anterior Intercostal Artery Perforator flap in 20 patients with small to medium-sized breasts.Patients and methods: From June 2018 to June 2021, twenty female patients underwent quadrantectomy followed by reconstruction using an AICAP flap. Results:The surgical excision margins were negative in all patients and no re-excision was needed. The dimensions of the flap were matching the defect size or were slightly larger due to anticipation of tissue shrinkage post radiation, with a mean of 7 × 5 × 3 cm (range of 4.6-10 × 3-6× 2-5 cm). The postoperative complications were observed in only one patient (5%) in the form of mild wound infection. An average percentage of excellent to good results was obtained in 95% of cases. Conclusion:The AICAP flap is an important addition in the field of oncoplastic immediate reconstruction after BCS, especially in patients with small to moderate breast sizes. The technique is oncologically safe and provides improved aesthetic results after quadrantectomy for tumors in the lower quadrants of the breast.
Background:The conventional open omental patch repair is the gold standard treatment for peptic ulcer perforation (PUP). Laparoscopic management has been advocated for the treatment of perforated peptic ulcers since 1990, but many concerns still exist about the technique's viability and safety. Objective: The aim of the current study is to compare the results and outcome of open versus laparoscopic repair technique for perforated peptic ulcers. Patients and methods: A total of 73 cases with a preoperative clinically diagnosed with peptic ulcer perforation were distributed randomly into two groups to perform either open or laparoscopic repair with an omental patch comparing their operative and postoperative results. Results:In comparison to open surgery, laparoscopic PUP repair led to quicker oral eating and bowel movements, less postoperative discomfort, less superficial wound infections, fewer pulmonary and overall problems, secondary intervention, and a shorter hospital stay. Its sole drawback was a longer operating time. Conclusions: Laparoscopic technique is a safe and feasible treatment modality for PUP with superior outcome when compared to open surgery.
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