Surgery, Gastroenterology and Oncology

Read article Associating liver partition and portal vein ligation (ALPPS) is nowadays an established surgical strategy for patients with liver tumors who are not amenable for upfront hepatectomy because of a too small future liver remnant (FLR) (1).
In these patients, we proposed a new technical variant of ALPPS, called parenchyma sparing ALPPS, consisting in shifting the transection plane though segment 4 (instead of the falciform ligament), thus increasing the FLR (2). The transection plane was established and performed under guidance of intraoperative ultrasound, ensuring oncological m....[more]

Read article Objective: The COVID-19 has quickly climbed to a global pandemic and hospitals had to adjust in order to manage the resources available. The aim of this article was to expose our experience and the means used to avoid delay in treating oncologic patients.

Methods: Collection of data from all patient who underwent elective colorectal surgery for neoplasia during the state of emergency (between March 16th and May 16th 2020) and compared the surgical outcomes with the outcomes of the previous year.

Results: A total of 28 patients received col....[more]

Read article Background: Emergency surgery for colon cancer is associated with high morbidity and mortality rates. Herein, this study was conducted to estimate the incidence and to detect the risk factors leading to mortality in cases of obstructed left colonic carcinoma.

Methods: This prospective research included 150 patients diagnosed with obstructed left colon cancer and underwent surgical intervention. Based on the incidence of early mortality, they were divided into two groups; the survival and the deceased ones.

Results: Mortality was encountered ....[more]

Read article Background: Since 2004, 6 months of postsurgical adjuvant chemotherapy with combination of 5-FU/LV or oral Capecitabine and Oxaliplatin has been the standard of care worldwide for patients with stage III colon cancer. Objectives: to evaluate the efficacy of 3-months of Capecitabine and Oxaliplatin (CAPOX) followed by 3 months Capecitabine alone as adjuvant treatment in stage III colon cancer.

Methods: This is a prospective study that included 50 patients with stage III colon cancer who presented to National Cancer Institute, Cairo University to receive adj....[more]

Read article Background: In the setting of perforated peptic ulcer (PPU) peritonitis, empiric antimicrobial therapy is initiated perioperatively and adapted according to the culture sensitivity. The aim of the study is to describe the microbiota found in the peritonitis due to a PPU, and to evaluate the predictors for bacterial or fungal infection.

Material and methods: We performed a single-centre, retrospective observational study of all consecutive patients who presented with PPU peritonitis and underwent emergent surgery in Saint Pierre University Hospital, Brussel....[more]

Read article Purposes: Patients with perforated peptic ulcer (PPU) present with signs of sepsis and appropriate management can be offered to achieve an optimal outcome of disease. We propose evaluating the severity of intra-abdominal sepsis in case of PPU with a new score called TNM, name borrowed by cancer staging, with the aim of assess its predictive value.

Methods: We included 183 patients with diagnosis of complicated PPU. We defined categories T (Temperature), N (Neutrophils count) and M (MOF); then, patients were grouped in stages (0-IV). Variables analysed were....[more]

Read article Background: Laparoscopic appendectomy is a safe and effective procedure for acute appendicitis. But several researchers found that performing laparoscopic appendectomy for complicated appendicitis may carry a risk of postoperative intraabdominal abscess development, and that’s why some surgeons use the intraabdominal drain. In our study we aimed to assess the effect of the drain in laparoscopic appendectomy for complicated appendicitis.

Methodology: This is a prospective comparative study which was performed at Ain Shams University Hospitals between Sept....[more]

Read article Background: Incisional hernia is an undervalued complication after stoma closure, with rates about 40%. Mesh-reinforced stoma reversal might be a simple and applicable approach to decrease the frequency of incisional hernia. There is a current debate about efficacy of this technique in preventing incisional hernias following stoma closure.

Methods: In this prospective clinical study, all patients with temporary stoma who admitted to Mansoura University Hospital at the period from February 2019 to April 2021 and fulfill the eligibility criteria were distrib....[more]

Read article Background: Oropharyngeal cancer is the most common type of head and neck cancers, with a 5-years survival of 64.7%. In the last 40 years risk factors and etiology changed, from the incidence associated mostly with tobacco and alcohol to HPV infection in 70% of the cases. Treatments that are standard of care for OPSCC include chemotherapy, radiotherapy or combination of surgery and radiotherapy have a high chronic treatment-related toxicity and functional loss. These therapies have significant impact on the quality of life (QOL) of survivors of oropharyngeal squamous cel....[more]

Read article Having in mind the continuous development of computed tomography imaging, the aim of this review is to discover the latest information based on Hounsfield measurements that can aid the modern urologist in establishing a better diagnosis and treatment for the lithiasis of the urinary tract. We conducted a literature search in PubMed and UpToDate databases using the key words in order to discover the latest publications that address computed tomography in urological pathology. The series of studies presented in this review show great promise and although there is no consensus to ....[more]

Read article Spontaneous duodenal hematoma is a rare condition, mainly occurring in relationship to the administration of anticoagulants. Rare case reports have described an association with pancreatitis. This paper aims to present the case of a patient with type A hemophilia who developed spontaneous intramural duodenal hematoma during all-oral antiviral therapy for chronic HCV hepatitis. Furthermore, the paper reviews existing data on incidence, diagnosis and management of this condition. Direct acting antiviral agents have proven very safe and effective in curing hepatitis C (HCV) infect....[more]

Read article Undescended cecum is a rare congenital abnormality; upon development of acute appendicitis though, the high position of the cecum results in atypical clinical symptomatology. We present a rare case of appendicitis in a patient with undescended cecum, which we managed laparoscopically, combining the appendicectomy with orthotopic repositioning of the cecum.

CASE PRESENTATION

A 26-year old Caucasian female patient presented to our surgical admissions unit with short history of abdominal pain in the right hypogastrium, radiating to the right flank. Prov....[more]