bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of preoperative portal vein thrombosis on the outcome of living donor liver transplantation
Authors: Abdelghaffar M F , Rady M A , Kamal K M , Mahgoub M A 
Published: May 2020

Abstract

Background
Portal vein thrombosis (PVT) is a common complication in terminal-stage liver disease. Its incidence in liver transplantation (LT) ranges from 2.1% to 26%. In the past, PVT was considered an absolute contraindication for LT, especially due to the technical difficulty involved. Nonetheless, since the mid-1980s, with the introduction of new surgical techniques, PVT is no longer considered an absolute contraindication in a larger percentage of patients.

Aim of the Work
to show the effect of preoperative portal vein thrombosis with its different extension degree on both patient and graft survival post living donor liver transplantation.

Patients and Methods
This retrospective cohort study was conducted on all the patients who performed living donor liver transplantation during the period from January 2010 till June 2017 at Ain Shams centre for organ transplantation (ASCOT). Our study included 240 cases who performed right lobe LDLT in that time interval and fulfilled the required data and time interval follow up. Those 240 cases were classified into 2 groups:

group A
Patients without preoprative PVT (200);

group B
Patients with pre-operative PVT. (40).

Results
1-year patients survival rates of patients with and without PVT were 75% vs. 85%. t 2-year patients survival rates of patients with and without PVT 75% vs. 84%. 1-year graft survival rates of patients with and without PVT were 75% vs. 84%; that 2-year graft survival rates of patients with and without PVT: 65% vs. 77%.

Conclusion
P.V.T not only makes the surgery more difficult and complex but it also affects the outcome of LT. However Further studies should be done taking in consideration different degree of extension of the thrombus as it has crucial effect on the outcome of the liver transplantation.
Review of Different Management Modalities of Penetrating Thoracic and Abdominal Trauma
Authors: Almaraghy A M , Farahat M S , Sallam K R , Elsaigh M M A 
Published: May 2020

Abstract

Introduction
The advanced trauma life support (ATLS) training program was developed to provide uniformity in the assessment and management of trauma patients. Every trauma patient is evaluated using the primary survey; a rapid reproducible physical exam designed to diagnose those conditions that are immediately life-threatening first. The primary survey consists of the sequential assessment and treatment of airway, breathing, circulation, disability and exposure/environment, represented by the mnemonic (A.B.C.D.E)

Objectives
To review the different management strategies of penetrating abdominal and thoracic trauma.

Data Sources
Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018.

Conclusions
In summation, most patients with PAT, especially gunshot wounds, still require surgery. On initial survey, patients who are hemodynamically unstable, have diffuse abdominal pain; evisceration, or peritoneal findings must go to the operating room. Patients with an altered sensorium, head injury, inability to cooperate with serial abdominal exams, or patients who will be undergoing an operative procedure somewhere other than the abdomen may be explored as well, depending on the comfort level of the trauma surgeon. This leaves a clinical subset that can be managed non operatively. In these patients, SNOM can drastically reduce the rates of negative and nontherapeutic laparotomies and result in a cost savings and safety benefit to the patient.
Incidence of Dysplasia in Patients with Barrett’s Esophagus
Authors: Elakkad H A , Elhefny A M M , Alsayed M A , Shawky K W 
Published: May 2020

Abstract

Background
Barrett’s esophagus is a condition which predisposes towards development of dysplasia and finally towards esophageal adenocarcinoma, a highly lethal tumour which has been increasing in incidence over the past three decades. Although BE is the single best identified risk factor for the development of esophageal adenocarcinoma, yet the overwhelming majority of Barrett’s patients will never develop this cancer.

Objective
To evaluate the incidence of dysplasia in patients with BE regarding risk factors such as gender, smoking, obesity, patient’s age, duration of reflux, treatment received, associated disease as DM and esophageal histopathology.

Patients and Methods
The study was conducted on 30 patients previously diagnosed with BE. The patients were selected according to some inclusion criteria such as being diagnosed by upper GI endoscopy and a biopsy was taken. Patients with history of previous anti-reflux surgery were excluded.

Results
A strong correlation was found between the incidence of dysplasia and male gender, mean age 58.17 years, smoking, DM, hiatus hernia and esophagitis.

Conclusion
As the incidence of dysplasia and esophageal adenocarcinoma continues to rise at an alarming rate, widespread endoscopic surveillance of Barrett’s esophagus patients is performed in order to detect any abnormality at an earlier and potentially curable stage. In addition to highlighting the risk factors that aggravates this pre-malignant condition.
LDLT Portal Vein Thrombosis: Technical Advances
Authors: Ahmed M B , Rady M A , Abd-errazik M A , Azzam A R M A 
Published: May 2020

Abstract

Background
portal vein thrombosis (PVT) is a common complication of end-stage liver disease with an incidence of 0.6–16% in patients with well-compensated disease (1–3), increasing up to 35% in cirrhotic patients with hepatocellular carcinoma.

Aim of the Work
the aim of the study is to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis, and post-operative complications.

Patients and Methods
This is a retrospective cohort study to compare between thrombectomy of PVT using vascular clamps “eversion” & manual technique “modified eversion” during liver transplantation regarding operative time, degree of blood loss, portal vein rethrombosis & post-operative complications.
The study was conducted as retrospective study of 33 adult patients who underwent LDLT at Ain Shams Specialized Hospital, Ain Shams University, Cairo, Egypt, between January 2016 and July 2018.

Results
the mean child score was 9.55 and the median hospital stay was 12 days. Based on review manager statics program, the PVT recurrence was non-significant (P = 0.295, Test value: 1.096). However, the blood loss was significant (p &lt; 0.029, test value: -2.186) and the surgical time was significant (p = 0.013, test value: 2.633).

Conclusion
portal vein thrombosis (PVT) represents a significant technical challenge in liver transplantation and for many years was considered a relative contraindication. While advances in surgical techniques, axial imaging, and alternative inflow reconstruction options have made liver transplantation possible in transplant candidates with PVT.
A Comparative Study of Residual Volume in Donors for Living Donor Liver Transplantation
Authors: Asaad N M D , Shaker H Z , Abdelbaset H S , Abdelhamid M A 
Published: May 2020

Abstract

Introduction
Living donor liver transplantation (LDLT) was introduced in 1989 to overcome the severe shortage of size-matched DD organs for pediatric recipients. Given the increasing shortage of DD grafts for adults in North America and Europe, living donation (LD) was now being explored as a potential solution to the shortage of DD organs for adults also.

Aim
This study aims at the exploration of this last point. Whether or not minimizing the residual volume in donors after LDLT affects donors’ morbidity. Concentration will be on postoperative donors’ bilirubin level, liver transaminases pattern and complications according to Clavien’s scale.

Patients and Methods
It is a Comparative Retrospective Observational Cohort study included 44 liver donors operated upon in Ain Shams Specialized Hospital Liver Transplantation Unit and in Egypt Air Liver Transplantation Unit from January 2014 to April 2017.

Results
There was no significant difference between two groups regards age, gender, fibrosis, steatosis, operation center, postoperative bilirubin (After how many days it returned to normal, maximum and mean postoperative bilirubin), postoperative complications (didn’t pass grade 2 in group A and grade 3 in group B), liver enzymes (postoperative AST and ALT) and Hospital stay, There were no difference between the two groups in the follow up except for elevation of liver enzymes that didn’t return to normal for more than 15 days in donor 9 and elevation of bilirubin in donors 3, 4 and 10 in group (A) and in donors 13, 24, 25, 26, 32, 33 and 43 in group (B).

Conclusion
It is concluded that donors with low RVs “not less than 33%” could be chosen and operated upon with no significant complications postoperatively that could affect donors’ safety, We suggest that regular follow up of donors is recommended for 5 years. Also more research regarding RV, donors’ safety, selection and complications is recommended as Egypt is the first country in liver disease worldwide.
Laparoscopic sleeve Gastrectomy and its effect on Gastro oesophageal reflux disease
Authors: Abadir A F , Hefny A M M , Elghandor A M , Kirolos A M A 
Published: May 2020

Abstract

Background
Obesity continues to be a leading public health concern associated with many comorbidities and major hindering effect on the daily lifestyle of many people around the world. Surgical treatment for obesity has proved that it is the best and most effective, durable means of preventing the life-threatening complications and serious problems associated with morbid obesity.

Objective
This study aims at identifying the effect of LSG on UGI symptoms after a mean of 6 months of follow up.

Patients and Methods
Our study was conducted on 25 morbidly obese patients undergoing LSG for weight reduction. Thorough history, clinical examination and investigations were applied including the validated Rome III Diagnostic questionnaire and UGI endoscopy on cases with sever symptoms. Patients were examined before surgery and had no primary complications as bleeding or leakage in the early post-operative period. Patients were followed up for a mean of 6 months regarding UGI symptoms specially GERD using the same validated Rome III Diagnostic questionnaire.

Results
GERD prevalence didn’t significantly change although a significant number of patients recovered from GERD which support the theory that the mechanism of upper GI symptoms after LSG is mainly due to altered motility patterns rather than acid-related disorders.

Conclusion
Our results show that LSG represents a safe and effective procedure to achieve significant weight loss. GERD which was considered to be a main troublesome impact of LSG showed no significant change in prevalence, on the contrary appear to abolish the symptom in a significant number of patients who complained of GERD.
Analysis of Adult to Adult Living Donor Liver Transplant Biliary Complications Using Non-Stented Biliary Anastomosis
Authors: Abdelaal A A , Abdelbasset H S , Saber H S , Sayed R M 
Published: May 2020

Abstract

Background
biliary tract reconstruction during liver transplantation (LT) is the final technical step and the cornerstone of the procedure and is often performed by a duct-to-duct anastomosis. Rarely, recipient and donor biliary stump discrepancies or liver disease-related reasons could lead to a hepaticojejunostomy.

Purpose
To clarify the role of non-stented biliary anastmosis in reducing biliary complications in adult to adult living donor liver transplant and ending the era of using intraductal removable stent.

Patients and Methods
this is a retrospective Single arm Cohort study. Our study was performed in Egypt by following the results of 80 cases of adult to adult living donor liver transplant using non-stented biliary anastomosis in Airforce specialized hospitals and Nasser institute in Cairo. Study period was from July 2015 to June 2018.

Results
The rate of biliary complications in non-stented patients was 23/80 (27%), and (27%) is subdivided as follow; (18%-strictures, 9%-leaks, and 1%-mixed), ) . All biliary complications had been treated with successful outcome representing 20/23(87%), while persistent biliary complication was in 3 (13%). Treatments used in biliary complications were (ERCP n = 22, PTC n = 5, Rendezvous n = 2, Surgical biliary-reconstruction n = 2).

Conclusion
Stentless biliary anastomosis is a well established and trusted method in biliary reconstruction in adult living donor liver transplant and has a less complications than stented duct to duct biliary anastomosis and biliary-enteric anastomosis and allow better management of biliary complication if occurred.
Congenital inguinal hernia repair with and without opening the inguinal canal
Authors: Sabry A A , Hassan T A , Allam A , Ali O K A 
Published: May 2020

Abstract

Background
Elective repair of congenital inguinal hernia is the most common surgery performed by pediatric surgeons and is considered the treatment of choice. The exact technique and steps involved in the repair differs widely among pediatric surgeons, many surgeons open the roof of inguinal canal while preserving the external ring or opening it, this is called the modified Ferguson, s technique. In infants, the inguinal canal is short and virtually the internal and external rings lie over each other so many surgeons also like to perform the whole operation without opening the external oblique aponeurosis distal to the external ring, this technique is called the Mitchell Banks technique.

Objective
To compare both techniques regarding intraoperative time, incidence of intraoperative and postoperative complications to pass our experience in a trial to reach an ideal surgical technique for congenital inguinal hernia repair.

Patients and Methods
In this study, 60 cases of congenital inguinal hernia were randomly selected and divided into two equal groups where group A underwent the repair with opening the external oblique aponeurosis and group B underwent the repair without opening the external oblique aponeurosis.

Results
As regard the postoperative complications, the patients who underwent the Ferguson’s technique experienced more postoperative pain with statistically significant more incidence of postoperative hydrocele than the Mitchell banks technique, no complications occurred postoperatively other than hydrocele in our study.

Conclusion
Our study results, we can approve that Mitchell Banks technique is easier, consumes less time than Ferguson’s technique with less incidence of postoperative complications and pain which can make this technique better for congenital inguinal hernia repair in children aging 2 years or less.
Evaluation of using stromal vascular fraction and platelet rich plasma in the treatment of androgenetic alopecia
Authors: Osama A B , Ahdallah Elfeky K , Ali E K M , Mamdouh N A 
Published: May 2020

Abstract

Background
Platelet Rich Plasma (PRP) is based on the release of growth factors stimulating the initiation/extension of anagen phase as well as promoting vascularization, Adipose Derived Stem Cell (AT-ADSCs) treatment through injection of stromal vascular fraction were recently introduced as an alternative potential therapeutic application for hair growth.

Purpose
This study aims to compare the efficacy, safety and adverse effects of using lipo-aspirate stromal vascular fraction versus Platelet Rich Plasma injection in the treatment of Androgenetic Alopecia (AGA).

Patients And Methods
Forty randomized patients were treated by PRP, and SVF. Each patient was evaluated. And each lesion was treated by those modalities, patients received three sessions with one month interval for 3 months, follow up after 3 months.

Results
A highly significant improvement &lt;0.001 in terminal hair count of SVF group evaluated by videodermoscopy assessment of AGA. That were confirmed by highly significant improvement in inter-mediate hair count and mean caliber (&lt;0.001) associated with high incidence of side effects especially headache and erythema.
In contrast. PRP group showed significant improvement 0.048 in terminal hair count and non-significant improvement in inter-mediate hair count and of mean caliber with minimum side effects.
SVF group showed a significant improvement in terminal hair count than PRP and a highly significant improvement in Inter-mediate hair count.
Regard the clinical improvement and photographic assessment, SVF evoked upper hand of clinical improvement than PRP without statistically difference.
Also, side effects of SVF showed highly significant pain, headache and erythema but no serious adverse events.
Our study suggests that was significant improvement in AGA after PRP and highly significant after SVF therapy, with significant difference of SVF in terminal hair count and highly significant in vellus hair. Both modalities could effectively and safely he used to treat AGA.

Conclusion
our study suggested that there was significant improvement in AGA after both PRP and highly significant after SVF therapy. The results indicated a significant difference between PRP and SVF regarding terminal hair count and highly significant for vellus hair count, but non-significant difference in hair diameter. Both modalities could effectively and safely be used to treat AGA and there was statistically improvement in AGA after both PRP and SVF therapies.
Predictive Factors of Difficulty of Laparoscopic Management of Cancer Rectum
Authors: Hanna H H , Ibrahim M , Gerges M W W F 
Published: May 2020

Abstract

Background
rectal cancers compromise approximately 25% of all primary colorectal cancers and follow a different natural disease course compared to colonic tumours, also it is well established that surgical approach, local recurrence rates and associated complications of rectal tumours are distinct from colonic ones.

Purpose
to use the previously mentioned factors that can influence the difficulty of performing laparoscopic anterior resection. And by using standardized operative time as an end point build reliable study models thys predicting operative difficulty for clinical use.

Patients and Methods
this is a prospective case series descriptive study analyzing the predictive factors of laparoscopic approach in surgical management of rectal carcinoma. Clinical records of listed patients that underwent laparoscopic anterior resection at Ain Shams University Hospitals were reviewed. Clinical records of listed patients that underwent laparoscopic anterior resection at Ain Shams University Hospitals from March 2018 to September 2018 were reviewed.

Results
some factors collected from the patients data as high BMI, old age, intraoperative blood loss and tumor staging may predict the difficulty of laparoscopic intervention for cancer rectum.

Conclusion
laparoscopic resection for low rectal cancers is a feasible technique and with proper training it can be performed safely with acceptable rates of overall morbidity and by taking into consideration the above mentioned factors that may predict the difficulty of Laparoscopic intervention in order to have the best outcome from the decision of Laparoscopic anterior resection for patients with cancer rectum.
Identification of Preoperative Risk Factors Associated with the Conversion of Laparoscopic to Open Appendectomies: Prospective Randomized Study
Authors: Ebied E F , Darwish A A , Khalil A A , Elhefnawy H R M 
Published: May 2020

Abstract

Bachground
the principal advantages of this approach are a more precise diagnosis of appendicitis, reduction in post-operative pain, fewer superficial-surgical-site infection, earlier return to normal activity and reduction of the duration of hospital stay.

Purpose
to assess the preoperative patient and surgery risk factors that increase the likelihood of conversion of a laparoscopic appendectomy to an open Appendectomy in Egyptian patients.

Patients and Methods
this study was conducted in El Demerdash Hospital; Ain shams University, from December 2017 to June 2018. The study was conducted on 30 patients with suspected appendicitis.

Results
there were 30 patients identified who underwent an initial laparoscopic approach for acute appendicitis. The age range was from 18 to 52 years. The Female to Male ratio was 19:11. Of the 30 initial LA, 9 cases were converted to OA (30%).

Conclusion
surgeon can initiate open appendectomy or aim to have a low threshold of conversion if any of the above mention risk factors present in combination.
Conventional Laparoscopic Nissen Fundoplication versus Rossetti’s Modification in Management of GERD; A Comparative Study
Authors: Elfiky K A , Elsaeed K , Hassan M I , Ain-shoka A A , Elsayed M A , Hanafy D M 
Published: May 2020

Abstract

Background
gastroesophageal reflux disease (GERD) is increasingly prevalent and costly, and it may affect as much as 20% of the western population. The pathophysiology of GERD is not due to acid overproduction but rather mechanical dysfunction centered around the lower esophageal sphincter (LES). Furthermore, the mainstay of GERD treatment, proton pump inhibitors (PPIs), have come under scrutiny because of worrisome side effects.

Aim of the Work
to prospectively compare between laparoscopic Nissen fundoplication and its Rossetti’s modification as anti-reflux procedures along with their operative and post-operative outcomes.

Patients and Methods
this is a prospective randomized study that was conducted on twenty (20) patients presenting to Ain-Shams University Hospitals in whom fundoplication was indicated for management of chronic GERD and was operated upon starting October 2016 to October 2018 with minimal follow up duration of one year.

Results
both procedures were nearly efficient and equal as regards the symptomatic control for the patients, the improvement in their quality of life, healing of esophagitis restoration of the high pressure zone, and post-operative hospital stay, while the Nissen’s procedure was nearly similar to the Rossetti’s modification in the aspect of post-operative dysphagia and gas-bloat syndrome, the modified Rossetti procedure showed significant superiority regarding the operative time, the incidence of intra-operative bleeding and splenic injury.

Conclusion
the Rossetti procedure carried better results in the operative time, operative bleeding and splenic injury though it showed nearly no difference in incidence of post-operative dysphagia.