Surgery, Gastroenterology and Oncology

Introduction: MRI is one of the main tools for staging and assessing response to neoadjuvant therapy in locally advanced rectal cancer. However, there is no consensus on its role in restaging. The aim of this retrospective study was to assess the imaging response with MRI and to compare restaging MRI with histopathological findings in patients with locally advanced rectal cancer who underwent neoadjuvant therapy.

Material and Method: A significant difference was found between staging and restaging MRI in clinical stage T (Z=-5.03, p<0.0....[more]

Introduction: Cervical cancer (CC) continues to be a significant problem in Bulgaria, with very high morbidity and mortality. The reasons for this are manifold – besides the lack of

primary prevention and screening, there are also issues related to the treatment process. This study aims to collect results and analyses data on the initial management of CC, focusing on preoperative radiotherapy and its negative impact on the survival of patients with this type of cancer in Bulgaria.

Materials and methods: This is a retrospectiv....[more]

Background: Metabolic associated fatty liver disease (MAFLD) can significantly increase the prevalence of chronic complications in patients with T2DM. Objectives: to analyse the association between the thyroid hormones and MAFLD in T2DM Egyptian patients.

Methods: This case control study was conducted on 180 T2DM patients with and without MAFLD who admitted to Department of Internal Medicine, and Endocrinology Unit, Faculty of Medicine, Menoufia University from December 2022 to October 2023. Patients were categorized into three groups to a....[more]

Background: hepatic hemangiomas, primarily affecting adults in their fourth and fifth decades, are common benign mesenchymal hepatic tumors. The management of giant hepatic hemangiomas, defined variably as greater than 4 cm to 10 cm in diameter, is a clinical challenge due to their potential size and associated symptoms. This study compares two minimally invasive treatment methods: trans-catheter arterial bleomycin chemoembolization (TACE) and ultrasound and fluoroscopy-guided transhepatic bleomycin sclerotherapy (PLIB), in the treatment of giant hepatic hemangiom....[more]

Background: Hepatocellular carcinoma (HCC) is a major global health concern, particularly in developing countries. Trans-catheter arterial chemoembolization (TACE) is a widely accepted nonsurgical treatment for unresectable HCC, but it is often accompanied by postembolization syndrome (PES), characterized by fever, nausea, and abdominal pain. This study aims to investigate the factors influencing the development of PES in TACE-treated patients.

Methods: This prospective cohort study included 51 patients with histologically confirmed HCC un....[more]

Background: The selection of intracorporeal anastomosis (ICA) versus extracorporeal anastomosis (ECA) after laparoscopic right hemi-colectomy remains a debatable issue. We aimed to compare the early and late outcomes between the two different technical groups (ECA versus ICA) utilizing the propensity score matching analysis.

Methods: For the period from January 2013 to June 2023, we studied 90 consecutive patients who undertook laparoscopic right hemicolectomies. We classified them into ICA and ECA groups. Propensity score matching analysi....[more]

Background: To maintain the less invasive approach to cholecysto-choledocholithiasis

treatment, other alternatives have been suggested, including single-step and two-step procedures. Aims and objectives: To assess the safety, accuracy, and effectiveness of Rendezvous techniques as a single-step treatment for cholecysto-choledocholithiasis and compare two different techniques (Dormia basket and Guide wire) regarding operative timing, safety, feasibility, failure, and complications.

Material and Methods: This research was done on 40 ....[more]

Laparoscopic distal pancreatectomy is the gold standard procedure nowadays for the treatment of symptomatic benign, premalignant and malignant pancreatic body and tail lesions. Tumor infiltration of the splenic artery (SA) near its origin, as well as the engagement of the splenic vein (SV) near its confluence with the superior mesenteric vein (SMV), or even localization on the body in front of the celiac trunk, could be a reason for technical difficulties. In such cases the most easily accessible major landmark is the common hepatic artery (CHA). The aim of the current article is....[more]

Gastric carcinomatosis is an ominous disease, with a survival of 3-6 months. In the last decade, cytoreduction surgery and hyperthermic chemotherapy by laparotomy have made progress in the treatment of carcinomatosis. Laparoscopic surgery has shown its benefits in the treatment of colon and gastric cancer, obesity, with lower rates of morbidity, shorter hospital stays, and early return to cancer treatment. There are few studies on the use of laparoscopy in gastric carcinomatosis, Arjona et al. (2021,2023) put together an international registry of laparoscopy and carcinomatosis, wh....[more]

A cryptoglandular abscess, which can result in a perianal abscess and fistula, is caused by an anal gland infection. An anal fistula occurs in 40–66% of perianal abscesses. The

general indications for this method range from high trans sphincteric fistulas to "short" (3 cm) trans sphincteric fistulas to inter sphincteric fistulas. We present the case of a 36-year-old patient who has a trans sphincteric anal fistula. The patient had an anal abscess that was drained in emergency. A seton was placed when an internal opening in the anal canal was detected. Local....[more]

Introduction: Eosinophilic enteritis (EE) is an uncommon condition which belongs to primary eosinophilic gastrointestinal disorders (EGIDs). The pathogenesis and etiology of EGIDs remain uncertain. Nowadays there are no gold-standard diagnostic criteria for EGIDs. The first-line treatment for EGIDs is glucocorticoid administration. Surgery may be recommended when a definitive diagnosis of EGIDs cannot be made and it is mandatory when complications occur.

Case report: A 72-year-old Caucasian female presented to the Emergency Department with....[more]

Introduction: In all pathologic types of gastric cancer, adenocarcinoma is the most common, whereas the incidence of adenosquamous carcinoma (ASC) remains extremely low, accounting for less than 1% of total gastric malignancies. Due to the rarity of ASC, limited data are available to conclude the histogenesis, clinicopathologic characteristics, optimal treatment strategies, and prognosis. This rare clinical entity exhibits a higher prevalence in men, particularly in Asians, and typically manifests at advanced stages.

Case report: In this r....[more]