bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Postoperative Complications between Conventional Diathermy Haemorrhoidectomy and Harmonic Scalpel Haemorrhoidectomy
Authors: El Naser Amr Abd El Raouf Ali Abd , Said Kamal Mamdouh Kamal El , El Ghandour Abd El Rahman Mohamed , Ahmad Mennat Allah Muhammad Youssuf 
Published: August 2023

Abstract

Background
For symptomatic grade III and IV haemorrhoids, some form of hemorrhoidectomy remains the accepted modality of treatment. The traditional methods like the Milligan-Morgan method and the Ferguson‟s method have been in practice for more than half a century. Recently we acquired the Harmonic system. It is an ultrasonic dependent technology, using waves to both seal and cut vessels and tissues in a hypothermic condition, now widely used for hemorrhoidectomy. This study will give a comprehensive overview on differences between conventional diathermy haemorrhoidectomy and Harmonic scalpel haemorrhoidectomy focusing on post-operative complications mainly postoperative pain, bleeding, anal stenosis and peri-anal fistulae occurrence.

Objective
To compere between conventional diathermy hemorrhoidectomy and Harmonic scalpel hemorrhoidectomy as regards post-operative pain, bleeding, anal stenosis and peri-anal fistula occurrence.

Patients and Methods
It is a prospective study conducted over 40 patients with grade III and IV hemorrhoids, randomly divided into two groups to compare between conventional diathermy hemorrhoidectomy, Harmonic scalpel hemorrhoidectomy as regards post-operative pain, bleeding, anal stenosis and peri-anal fistula occurrence.

Results
An overall favorable trend exists toward Harmonic scalpel hemorrhoidectomy in all parameters of the current study, in another word, the postoperative complications mainly pain, bleeding, anal stenosis and peri-anal fistula occurrence was much lesser in the Harmonic group.

Conclusion
Harmonic scalpel hemorrhoidectomy is a sutureless, hemorrhoidectomy technique dependent on an ultrasonic unit to achieve vessel and tissue sealing. It is safe and effective, has less blood loss, postoperative pain, bleeding, anal stenosis and perianal fistula occurrence compared to conventional diathermy hemorrhoidectomy.
Early Outcome of Superomedial Pedicle as Extreme Oncoplastic Procedure versus Modified Radical Mastectomy in Patients with Stage T3 Breast Cancer Not Responding to Neoadjuvant Chemotherapy
Authors: Osman Ahmed Gamal-elDin , Atrash Osama Ali El , AbderRazik Mohammad Ahmad , Zaki Michael Bahaa 
Published: August 2023

Abstract

Background
Breast cancer, according to national cancer institute, is the most common site of cancer in women in Egypt as it accounts for about 38.8% of total malignancies among Egyptian females; it is an important cause of mortality among women.

Aim of the Work
To assess the feasibility of extreme oncoplasty (achieving negative margins) for T3 breast cancer patients not responding to neoadjuvant chemotherapy by using a superomedial pedicle flap.

Patients and Methods
This study was conducted on 30 female patients with stage T3 breast cancer not responding to neoadjuvant chemotherapy with no skin involvement or upper medial quadrant tumor, with large breast size (cup D), accepting both intervention modalities and fit for both anesthesia and radiotherapy. It was performed at the (General Surgery Department) at Ain Shams University Hospitals and El Haram specialized Hospital starting from March 2020. Approval of the Ethical Committee and written informed consent from all participants were obtained. Patients were divided into two groups. Group A includes 15 patients underwent Modified radical mastectomy with axillary clearance. Group B includes 15 patients underwent Superomedial pedicle mammoplasty and axillary clearance.

Results
Superomedial pedicle mammoplasty is equivalent to modified radical mastectomy in terms of oncological safety, with advantages over mastectomy in terms of quality of life and esthetic outcomes. Thus, Extreme oncoplasty provides an alternative to Modified radical mastectomy, extends the scope of breast conservation, provides better clinical outcomes, and improves quality of life.

Conclusion
This study showed that superomedial pedicle mammoplasty technique is a feasible extreme oncoplastic approach for patients with large tumors and not responsive to neoadjuvant chemotherapy considered for Modified radical mastectomy with acceptable complication rates, negligible rates of reexcision and no early recurrence in 3 months period.
Evaluation of Round Block Technique in Different Juxta-Areolar Malignant Lesions in Early Breast Cancer
Authors: Moghny Ashraf Abd El , Elmoaty Karim Fahmy Abd , Ibrahem Abdalla Hamed , Roman Mina Aref Abd Elmalak 
Published: August 2023

Abstract

Introduction
Conservative surgery has become a well-established alternative to mastectomy in the treatment of breast cancer. However, in case of larger lesions or small-sized breasts, the removal of adequate volumes of breast tissue to achieve tumor-free margins and reducing the risk of local recurrance may compromise the cosmetic outcome, causing unpleasant results. To address these surgical techniques, the socalled oncoplastic techniques, have been introduced in recent years to optimize the efficacy of conservative surgery in terms of both local control and cosmetic results.

Aim of the Work
To evaluate round block technique in different juxta areolar malignant lesions up to 50 mm from areola in early breast cancer regarding oncologic, surgical and cosmetic outcome - post-operative complications.

Patients and Methods
A Clinical Interventional descriptive single arm randomized prospective study, conducted on 20 female patients presenting with juxta areolar malignant lesions up to 50 mm from areola in early breast cancer stages T1 and T2. Ages ranging 20 to 70 years to be treated using the “round block” technique.

Results
None of the patients had any malignant recurrence during follow up visits through 1 year after the surgical removal of the tumor proving that we had performed both techniques safely from oncological point of view. The cosmotic results were found to be excellent in 4 cases, very good in 11 cases, good in 3 cases, fair in 1 case, and poor in 1 case. Unacceptable outcomes (either fair or poor) were observed in only 2 cases who underwent 25% excision or in whom the resected area was part of the lower portion of the breast.

Conclusion
The round block technique is useful for performing breast-conserving surgery in the upper portion of the breast. However, if the excision volume is greater than 20% and/or excision of a part of the lower portion of the breast is required, other procedures should be considered.
Impact of Recipient’s Inflow Artery Selection on Hepatic Artery Thrombosis Post Living Donor Liver Transplantation
Authors: Abdelghaffar Mohamed Fathy , elsaid Youssef farouk Youssef, Kamal , Ghobrial Remon Mamdouh Mahfouz , Ismaeil Mohamed Osama Marei 
Published: August 2023

Abstract

Background
Hepatic artery reconstruction is one of the most important steps in liver transplantation, and complications associated with this vascular reconstruction, such as hepatic artery thrombosis (HAT) may have a significant influence on the recipients’ prognosis.

Aim of the Work
The purpose of this retrospective study is to evaluate whether the selection of the recipient’s right versus left hepatic artery for hepatic artery reconstruction as an inflow artery will influence the chance of HAT after living donor liver transplantation (LDLT).

Patients and Methods
This is a retrospective study that analysed and evaluated the hospital records of all patients who underwent LDLT at Ain Shams University specialized Hospital (ASCOT) from January 2010 to January 2020. Records of all 390 patients were reviewed and drop out of 101 patients was performed according to the exclusion criteria.

Results
The study showed that the right hepatic artery was used in 79.5% of cases while the left hepatic artery was used in 20.1% of cases in the study population. The incidence of HAT was 7.3% in the whole study population. On further analysis of the arterial complications and distribution according to the usage of the right or left hepatic artery as the recipient inflow artery, there was an increase in the incidence of HAT when the right hepatic artery was used (7.9 %) compared to left hepatic artery which was (5.2 %) although it did not reach statistical significance.

Conclusion
Incidence of HAT was generally higher following LDLT using the right hepatic artery as the recipient’s inflow artery.
Evaluation of De Epithelization Technique in Management of Pilonidal Sinus Disease
Authors: Abdraboh Ayman Abdullah , Eldin Mohamed Salah , Amer Ahmed F 
Published: August 2023

Abstract

Background
Pilonidal sinus disease (PSD) is a common disorder of the sacrococcygeal region. The incidence is reported in 6 per 100,000 individuals, this method is defined as a flap or graft of thinned cutaneous layer. Aesthetic surgeons usually perform this method for mammoplasty. In this method, after de-epithelization of the cutaneous tissue is performed, cutaneous flap and fatty tissue are inverted to fill the dead space (1). De-epithelialized skin grafts are used for many indications.

Objective
To evaluate De epithelization technique as a new approach in management of pilonidal sinus disease as regard post operative complications and recurrence rate.

Patients and Methods
This Cohort retrospective and prospective study will include 50 cases, admitted to Ain Shams University and Agouza Police hospital from august 2019 till February 2020 who met the inclusion criteria. A total of 50 adult patients with PSD were randomly allocated intraoperatively to undergo De epithelization technique.

Results
According to our scale evaluating outcome, De-epithelization technique is effective and safe with least post operative complications regarding pilonidal sinus disease.

Conclusion
It allows a quicker return to daily activities and reduces costs. Furthermore, we believe that the risk of recurrence may be reduced by increasing the angle of the natal cleft during this technique. Also, this method has a satisfying aesthetic outcome. This preliminary report suggests that this new surgical approach seems to be a reasonable method in the treatment of PSD, especially in patients with uncomplicated primary disease, and is worth studying further.
Retrospective Study between Re-sleeve Gastrectomy and Mini-Gastric Bypass for Failed Sleeve Gastrectomy
Authors: Lasheen Mohammed Ali , Monaem Ayman Hossam Eldin Abd El , Hamad Mohammed Abd El Fattah Mohammed 
Published: August 2023

Abstract

Background
Overweight and obesity represent a rapidly growing threat to the health of populations in an increasing number of countries. Indeed they are now so common that they are replacing more traditional problems such as undernutrition and infectious diseases as the most significant causes of ill-health.

Aim of the Work
The aim of this retrospective study is to compare between re-sleeve gastrectomy (RSG) and mini-gastric bypass (MGB) in patients who had previous failed sleeve gastrectomy in the last year concerning time required for operation and hospital stay, complications, and effect on weight loss and comorbidities for each operation.

Patients and Methods
This study is a retrospective cohart study which included 20 patients 10 of them underwent resleeve gastrectomy and 10 underwent minigastric bypass at Ain-Shams University El-Demerdash Hospital, Cairo, Egypt, From November 2019 to April 2020 with 6 months of postoperative follow up till October 2020.

Results
In our study we compared between re-sleeve gastrectomy and mini-gastric bypass as a revisional procedure for failed sleeve gastrectomy. MGB had longer mean operative time 103.5 mins. and longer mean postoperative hospital stay 3.6 days versus 91.9 mins. and 2.8 days respectively for RSG. Intraoperatively, bowel injury was reported in 20% of MGB cases versus bleeding which was reported in 20% of RSG cases.

Conclusion
Mini-gastric bypass and re-sleeve gastrectomy are efficient operations for reducing weight in morbidly obese patients and also in diabetic control. In patients who had previous failed sleeve gastrectomy; mini-gastric bypass had longer operative duration and postoperative hospital stay, more frequent bowel injury and leak in comparison with re-sleeve gastrectomy but improvements of weight loss, BMI, hypertension and DM were better with mini-gastric bypass. The less technically challenging nature of re-sleeve gastrectomy may be more widely applicable.
Comparative Study between Laparoscopic Single Anastomosis Sleeve Ileal Bypass (SASI Bypass) versus Laparoscopic Mini-Gastric Bypass (MGB/OAGB) in Controlling Type 2 Diabetes in Morbidly Obese Patients
Authors: Maaty Sameh Abdullah , Sabry Ahmed Mohammed , Nasr Mohammed El-Sayed Abdel-Wahab 
Published: August 2023

Abstract

Background
In our opinion, the most important criteria in the selection of a bariatric procedure remain the safety and efficacy in achieving both weight loss and remission of the metabolic consequences of obesity. Despite the intrinsic limitation imposed by a retrospective study, our results seem to confirm that LMGB is both safe and effective for the treatment of morbidly obese diabetic patients. Laparoscopic SASI bypass has been shown to be an effective, safe, and simple procedure for the treatment of morbid obesity and its associated metabolic consequences. Moreover, it results in minimal postoperative nutritional complications in comparison to other bariatric procedures. However, long-term follow-up period should be performed to evaluate postoperative weight loss, metabolic changes, and nutritional status of patients.

Objective
To compare Laparoscopic Single Anastomosis Sleeve Ileal (SASI) Bypass with Minigastric bypass (MGB/OAGB) in controlling type 2 Diabetes Mellitus in morbidly obese patients.

Patients and Methods
This study is a retrospective comparative study in which morbidly obese Patients with type 2 DM who underwent either Mini-gastric bypass or Single Anastomosis Sleeve Ileal (SASI) bypass with available preoperative Fasting blood Glucose, Hemoglobin A1c& serum cpeptide (As predictive measures for remission of diabetes after surgery) was collected & their data and results was compared to this1,3, 6 & 12 months postoperatively.

Results
As regard glycemic and lipid profile pre and postoperative mean values in MGB group, the present study showed that there were significant differences between before and after surgery as regard FBG, HbA1C, triglyceride, cholesterol, HDL and LDL. Laparoscopic mini-gastric bypass (MGB) is a technically simple and safe procedure in SSO patients. LMGB has the advantages of being a single stage procedure, being easily reversible and revisable in a laparoscopic procedure and does not sacrifice portions of the stomach or implant foreign materials. SASI bypass is a promising operation that offers excellent weight loss and metabolic result. The elimination of two ways for passage of food and one anastomosis decrease nutritional deficiency and the possibility of surgically related complications.

Conclusion
Metabolic surgery is a safe option for carefully selected patients with metabolic syndrome. The increased risk for type 2 diabetes and cardiovascular disease demands therapeutic attention for those at high risk. Our study suggests that both SASI and MGB are highly effective in controlling Diabetes mellitus, Hypertension and Hyperlipidemia.
Outcome of Superomedial Pedicle Flap for Lower Outer Quadrant Breast Cancer
Authors: Shehab Mohammad Helmy , Aref Muhammad Abdel Raheem Hussein , Ahmed Dina Hany 
Published: August 2023

Abstract

Background
Breast cancer is the most common cancer among women and is the second leading cause of cancer deaths. The surgical treatment of patients with breast cancer involves either breast conserving surgery or mastectomy, both of which can result in considerable asymmetry of the breasts. Breast reconstruction offers restoration of breast symmetry to such women. The patient needs to be aware that the reconstructed breasts will neither feel nor function like a normal breast but may help in restoring body image and self-confidence.

Objective
To evaluate the intraoperative and postoperative outcomes and showing advantages and disadvantages of Superiomedial pedicle flap for lower outer quadrant breast cancer in cup ≥ c.

Patients and Methods
It was a prospective study that included 10 patients aiming to assess outcome of the superomedial pedicle flap oncoplastic technique for lower outer quadrant breast cancer in oversized breast. This study was conducted at Ain Shams University Hospitals. Approval of the ethics committee and written informed consent from all participants were obtained.

Results
In our study, all of the patients had free safty magins as confirmed by the pathologist in our MDT proving that we had performed a superior medial technique safely from the oncological point of view. We were able to conduct an excellent cosmetic outcome for relatively large tumor excisions which fall in good and fair score groups as those two patients noticed asymmetry of the two breasts. None of our cases have had a poor or an ugly score. Overall, the satisfaction rate with this technique was high, with very few and easily manageable complications. There were no cases of NAC loss.

Conclusion
Superomedial pedicle can be safely utilized in large size breast reduction without increase of NAC necrosis. The technique is an efficient method to achieve minimal to moderate breast reduction with minimal NAC transposition. The primary surgical goals are attained by appropriate resection of the breast parenchyma. Moreover, a youthful and aesthetically appealing breast is achieved by maintaining superior and medial fullness and reshaping the breast using the parenchyma and skin envelope for support. Superomedial pedicle flap technique offers breastconserving surgery with wider margins offering safer oncologic control with more satisfactory cosmetic outcome.
Factors Favouring Laparoscopic over Laparotomy Technique of Vp Shunts: A Systematic Review and Meta-Analysis
Authors: Alyan Walid Atef , Osman Ahmad Gamal El-Din , Khalil Abdallah Hamed , Al-Sabbagh Muhammad Ahmad 
Published: August 2023

Abstract

Background
A systematic review and meta-analysis of studies concerning laparoscopically assisted ventriculo-peritoneal shunt placement. After using selection criteria, a total of 12 studies with 3173 patients were included in the systematic review.

Aim of the Work
To review, revise and redefine the role of laparoscope in the effectiveness of ventriculo-peritoneal shunt placement in a Meta-analytical form, minimizing procedurel and hospital stay together with postoperative complications in comparison to laparotomy techniques in patients with hydrocephalus and its role in revision of ventriculo-peritoneal shunts.

Methods
A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases. A manual search for reference lists was conducted. The protocol was prepared according to the interventional systematic reviews of the Cochrane Handbook, and the article was written on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines.

Results
There was a significant difference in terms of the distal shunt failure rate between the 2 groups, but the significance disappeared when proximal shunt failure was also considered, leaving a non significant trend toward lower overall shunt failure in the laparoscopic compared with the laparotomy group. The results of our meta-analysis clearly show that the laparoscopic technique is a safe, minimally invasive treatment option for the insertion of distal catheters. Laparoscopy can reduce the distal shunt failure rate and length of operation, while not reducing the overall shunt failure, overall infection rate, and length of hospital stay and might not reduce intraoperative complications.

Conclusion
The results of our meta-analysis clearly show that the laparoscopic technique is a safe, minimally invasive treatment option for the insertion of distal catheters. Laparoscopy can reduce the distal shunt failure rate and length of operation, while not reducing the overall shunt failure, overall infection rate, and length of hospital stay and might not reduce intraoperative complications.
The Possible Effect of Grape Seed Extract on the Adrenal Cortex in Streptozotocin-Induced Diabetes in Male Albino Rats: A Histological Study
Authors: Fahmy Esraa T , Saleh Hanan A , Raafat Mona H , Elkhateb Lobna A 
Published: August 2023

Abstract

Introduction
Induction of diabetes in rat models injected with streptozotocin (STZ) had led to increase activity of the hypothalamic-pituitary-adrenal (HPA) axis accompanied with hypercortisolism and adrenocortical growth. Proanthocyanidin, a grape seed extract (GSE) that was observed to have beneficial effect on different metabolic and inflammatory diseases.

Aim
To study the structural changes of the adrenal cortex in diabetic rats and the beneficial effect of GSE on the suprarenal cortical injury.

Materials and methods
35 adult male albino rats were divided randomly into 4 groups. Group I (control). Group II (GSE), rats received GSE orally (200 mg/kg), daily for 21 days. Group III (STZ), rats were injected with STZ (40 mg/kg) given intraperitoneal once. Group IV (STZ + GSE), rats received STZ as in group III. After rats confirmed to be diabetic, they were treated with GSE as in group II. After 21 days, the adrenal glands from all groups were dissected and processed for light microscopic examination. Morphometric and statistical analysis were also done.

Results
H&E stained section of Group III (STZ) showed increase in the capsular thickness and congested blood capillaries. Both zona glomerulosa & zona fasciculata showed increased thickness with some cells appeared with vacuolated acidophilic cytoplasm while others were shrunken with closely packed pyknotic nuclei. Inflammatory cells infiltration was also observed. Moreover, silver stain showed focal significant increase in thickness of the capsule, dense trabeculae and dense irregular reticular fibers of the cortex. Meanwhile, immunohistochemical results showed significant increase in the reaction for caspase 3 antibodies. Group IV (STZ + GSE) showed restoration of the cortical structure & organization nearly similar to that of control group.

Conclusion
It can be considered that GSE might have a protective effect on the structure of diabetic rats’ adrenal gland.