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Background: Post haemorrhoidectomy pain and delayed wound healing are the most annoying drawbacks to the patients and the surgeons. Topical application of sucralfate or lidocaine may help in reducing postoperative pain and promoting wound healing after Milligan Morgan hemorrhoidectomy.Methods: This study was designed as a single-center double blinded randomized placebo controlled trial at the Department of general Surgery Menoufia University, immediately after Milligan Morgan Hemorrhoidectomy, a total of 150 patients were randomly assigned to receive either 10% Sucralfate ointment, 5% lidocaine ointment or placebo ointment (control group). The primary outcome measure was pain intensity measured by a visual analogue scale at different time points after hemorrhoidectomy and the secondary outcome measure was wound healing.Results: There was no significant difference in age, gender, and number of excised hemorrhoid piles between the two groups. At the 1st ,3rd and 7th days after surgery pain intensity was significantly lower in sucralfate group (4.18±0.82, 3.92±0.72, 3.56±0.67) when compared to lidocaine group (5.06±1.11, 4.70±0.84, 3.93±0.75) and placebo group (6.17±1.26, 5.42±0.98, 4.55±0.84). At the 21st and 28th days no significant difference in pain intensity between groups (p > 0.05) with better wound healing in sucralfate group (P<0.05).Conclusions: Sucralfate was able to reduce the acute postoperative pain and improve wound healing after hemorrhoidectomy, local anesthetic lidocaine could help in pain control but without effect on healing.

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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.