Background: The purpose of this study was to compare between laparoscopic and open complete mesocolic excision (CME) with central vascular ligation (CVL) in right colon cancer.Methods: From January 2016 to December 2018, a prospective cohort study of 60 patients who diagnosed as operable right sided colon cancer was performed. The patients were classified into laparoscopic CME with CVL and open CME with CVL groups. Demographic variables, comorbidities, tumor location, intraoperative parameters, duration of hospital study, histopathological findings, postoperative complications and follow up data were compared between the two groups. Demographic variables included age and sex distribution. Intraoperative parameters included incision length, operative time and operative blood loss.Results: 60 patients were selected in this study. Both groups were the same in the age and sex distribution, potential comorbidities and tumor location. Patients in the Laparoscopic CME with CVL group had shorter incision lengths, longer operative times, less operative blood loss, shorter hospital stay, less number of retrieved lymph nodes , the same TNM (tumor nodes metastasis) classifications, similar histopathological findings and comparable incidence of postoperative complications.Conclusions: Laparoscopic CME with CVL procedure is a safe, valid and feasible surgical method for right colon cancers.
Background: Complete mesocolic excision (CME) as a standard surgery for left sided colon cancer is proven however there is a great debate and deal of discussion if the extra effort needed for it in right sided colon cancer worth the gain that is achieved. We aimed in our study to assess the outcome of CME with central vascular ligation for treatment of right sided colon cancer performed either laparoscopic (lap.) assisted or by open technique.Methods: This was a prospective randomized study on sixty patients who were presented with right sided colonic cancer. Patients were divided into two groups. Group (A) open one and group (B) lap. assisted group.Results: Both groups were comparable regarding demographic data, although operative time was significantly shorter in open group (p>0.001). Lap. assisted group achieved a significant difference as regards to blood loss, incision length, duration of hospital stay, resume of oral feeding, tumor to high vascular tie as well as higher number of harvested lymph nodes with no difference in recurrence rate and overall survival rate over a period of 3 years follow up.Conclusions: The principles underlying CME are anatomical and logical as it entails return back to embryology, and the results published points to the improved survival and decreased local recurrence particularly when it is performed in the proper mesocolic plane, using of laparoscopy may help in that due to better visualization of planes thus the gain of CME even in right sided colon cancer may exceed the pain in hand skilled colorectal lap. surgeons.
Background: Although sleeve gastrectomy provides a technically simple procedure with minimal effect on digestive tract it deprives the stomach of its ligaments of fixation which results in impairment of gastric functions, vomiting, axial gastric rotation in addition to bleeding or leakage from the stable line. Objective of present study is the effect of stable line fixation during sleeve gastrectomy.Methods: This is a prospective randomized study using closed envelop method carried on 100 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy (LSG) they were divided into two groups each is 50 patient group A underwent classic (LSG) with no fixation and group (B) with staple line fixation.Results: Patients were 68 females and 32 males with a mean age of 32.2±5.7 years, mean (BMI) 48.9±8.6kg/m2. postoperative vomiting, gastric axial rotation, impaired gastric emptying all were significantly higher in group A. Although both staple line bleeding and leakage were higher in the group A, but it was not statistically significant. Also, the operative time was shorter in the group A, but it was not significant.Conclusions: staple line fixation should be a step during sleeve gastrectomy as it regains the stomach its ligaments of fixation anatomically and so functions better less vomiting, less gastric axial rotation, better gastric emptying in addition to decreasing staple line bleeding and leakage with minimal effect on operative time.
Background: Paraumbilical hernia is a common disease and its repair is one of the most performed surgical interventions worldwide. The most important techniques in its repair are hernioplasty and herniorrhaphy and both differ significantly.Methods: We conducted a prospective randomized controlled trial to compare hernioplasty versus herniorrhaphy alone in small-sized paraumbilical hernia as regards local wound complications e.g., seroma and wound infection in addition to recurrence rates, operation time and overall cost, by comparison between two groups each comprising 50 patients.Results: There was no significant difference between both techniques regarding hernia recurrence as well as wound complication. On the other hand, herniorrhaphy reduced significantly incision size, time of operation and overall cost.Conclusions: Our study revealed that herniorrhaphy alone is better in small-sized paraumbilical hernia repair as it showed significant correlation with decrease incision size, time of operation and overall cost.
Background: Intracapsular total thyroidectomy is a rising new technique in management of benign thyroid disease seeking for safety. Our aim in this study is to evaluate safety and effectiveness of intracapsular technique in treatment of benign thyroid disease.Methods: this prospective study was carried out in department of general surgery, Menoufia University hospital and department of general surgery, Tala central hospital; from June 2018 to April 2019 on 58 patients with benign thyroid disease all had undergone intracapsular total thyroidectomy.Results: 58 patients underwent intracapsular total thyroidectomy. There was no recurrent laryngeal nerve injury either transient or permanent and no external laryngeal nerve injury. There was no parathyroid injury or hypoparathyriod complications.Conclusions: Intracapsular total thyroidectomy is a safe method in treatment of benign thyroid disease and can be done easily in central hospitals and non-highly specialized centres.
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