In addition to the fact that near-total thyroidectomy adds the advantages of total thyroidectomy (no recurrence) to those of subtotal thyroidectomy (low incidence of temporary and permanent hypoparathyroidism), it has a significant positive impact on thyroid-associated orbitopathy.

Background: Loop duodenal switch with sleeve gastrectomy is reported to be associated with accepted rates of diabetes remission in obese patients suffering from type II diabetes. We conducted this study to assess the metabolic outcomes of this operation on obese diabetic patients. Study type: Prospective longitudinal cohort study. Patients and methods: Twenty-five cases were included in the study with mean BMI of 61.15 kg/m 2 . All cases underwent open loop duodenal switch with sleeve gastrectomy. Patients were followed for up after operation for diabetic and metabolic changes. Results: The mean age of the included cases was 34.16 years. Patient weight and BMI were significantly decreased at follow up (p < 0.001). Lipid profile showed a marvelous improvement compared to baseline levels preoperatively. Blood glucose and HbA1c levels were significantly improved (p < 0.001). No significant changes were detected regarding bilirubin or calcium levels. Diabetes full remission was detected in 12 cases (48%) and 8 cases (32%) at 1 and 2 years respectively whereas diabetic control was found 4 cases (16%) at the previously mentioned follow up visits. Regarding complications, GERD was detected in 2 cases (8%) while leakage and intestinal obstruction were detected in one case (4%) for each complication. Conclusion: Based on the results of our study, it is evident that loop duodenal switch with sleeve gastrectomy is effective surgical method in the management of diabetes in obese individuals with accepted morbidity and mortality rates.

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Background: Angiogenesis plays an important role in goiter development with endothelial cell proliferation occurring before increased proliferation of the thyroid follicular cells and increase in both vascular endothelial growth factor (VEGF) and Angiopoietin-1 (Ang-1) in the serum and intrathyroid tissue. Objective: The aim of the current work was to measure the levels of VEGF and Ang-1 in patients with benign thyroid disorders before and after thyroidectomy and compare it to the normal control subjects. Patients and Methods: This prospective study included a total of 80 patients provisionally diagnosed as benign thyroid disorders and 50 apparently healthy subjects served as a control group, attending at Outpatient Clinics of Endocrine Surgery Unit, Mansoura University Hospital. This study was conducted between February 2017 to February 2020. Of the 80 patients, 12 (15%) were male and 68 (85%) were female and their age ranged from 19 to 60 years (median = 40.41 years). On admission, careful history taking, clinical examinations and different investigations were done. Results: Thirty patients had benign multinodular goiter, 20 had solitary follicular adenoma, 10 had diffuse toxic, 10 had nodular toxic goiter, and 10 had Hashimoto thyroiditis. In all patients, pre-operative circulating VEGF and Ang-1 levels were increased compared to controls (P<0.001), and a decrease after thyroidectomy was observed in the levels of VEGF (P<0.001) in all of them. This decrease was significant after total thyroidectomy compared to near total and hemi-thyroidectomy. Circulating Ang-1 were significantly increased (P<0.001) after thyroidectomy in all patients. Conclusion:It could be concluded that this study raise the potential for VEGF and Ang-1 factor to be used as biomarkers of the effectiveness of thyroidectomy in benign thyroid lesions. These results needs further investigations and may have potential prognostic implications.

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Four ports laparoscopic cholecystectomy (LC) has been the standard for treatment of the symptomatic cholelithiasis. Herein, the experience of two-ports LC regarding its safety and feasibility was given. This study was conducted in Theodor Bilharz Research Institute (TBRI) in the period from November 2017 till April 2018, as a prospective randomized study including one hundred patients with chronic calcular cholecystitis, which were divided into two equal groups. The study compared between group A (GA) which underwent four ports LC and group B (GB) which underwent two ports LC.The results showed that in GA, no cases were converted to open cholecystectomy. But, in GB only two patients converted to three-port laparoscopic cholecystectomy. There were no intraoperative complications encountered in any patient in both groups. In GA, operative time ranged between 28-62 minutes (mean±44.57) while in GB, operative time ranged between 39-134 minutes (mean±59.93); with hospital stay of three days in both groups. The pain score showed statistically significant differences regarding port-site pain (P value = 0.040). Significant lower analgesic demands were recorded in the 2 ports group. Scar satisfaction showed a marked statistically significant differences regarding the aesthetic results between the two groups (P value = 0.0319).

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