evaluation of routine central nodal dissection in radiologically node negative differentiated thyroid carcinoma

Background: thyroid cancer is the most common malignant disease in endocrine system and is rapidly increasing in incidence. The use of routine prophylactic central neck dissection for the treatment of differentiated thyroid cancer has been an area of debate over the past few decades

Aim of the Work: the primary aim of surgery was to resect disease, minimize the chance of recurrence and achieve this with minimal morbidity. Selecting the appropriate procedure is critical as not only does surgery provide initial therapy, but also optimizes the patient for adjuvant radioactive iodine [RAI] therapy when required

Patients and Methods: this study was conducted to evaluate the efficacy of prophylactic central lymph nodal dissection in patients diagnosed with differentiated thyroid carcinoma from several points of view including operative time, hospital stay, postoperative complications and most importantly the recurrence. Our patients were operated upon between August 2016 and August 2017 with minimal follow up of 6 months and follow up extended to 2 years after surgery

Results: Operative time was significantly higher in group B with a mean time of 141.68 +/- 12.72 as compared to group A. The most outstanding difference in terms of complications was detected in transient hypoparathyroidism that occurred in 16% of group B patients. A single case of recurrence was detected at 12 month in group A that was confirmed by fine needle aspiration cytology which required reoperation

Conclusion: there was no convincing evidence that pCND leads to an improvement in recurrence rate, overall survival, or any clinically significant variable when applied indiscriminately to DTC patients

Comparative study between laparoscopic assisted versus open left sided hemicolectomy and sigmoidectomy for cancer colon

Background: Traditionally, open procedure through exploratory incisions remains the gold standard approach for treating colorectal [CRC]. Laparoscopic colectomy was proved to be a better alternative to the open approach. Though in some studies, it was found that the length of the operation tends to be somehow longer. However, in experienced hands it has comparable oncologic outcomes. Moreover, the laparoscopic approach is associated with less postoperative pain, faster return of bowel activity, earlier resumption of oral intake and lesser hospital stay

Aim of the Study: to study and evaluate the effectiveness of laparoscopic left hemicolectomy and sigmoidectomy compared to the open left sided colectomy and sigmoidectomy for malignancy regarding operative time, length of hospital stay, return of bowel function, resumption of oral intake, postoperative pain perception, general postoperative complications, surgical site infections and early recurrence

Patients and methods: This comparative study has been conducted in El-Demerdash hospital, Ain Shams University - Cairo, Egypt and has included 60 patients where half of the patients underwent open left hemicolectomy or sigmoidectomy and the other half underwent laparoscopic left hemicolectomy or simoidectomy. We performed both procedures during the period between 1[st] of January 2016 and 1[st] of January 2017 with 12 months of follow up post-operatively

Results: In our study, the laparoscopic operation was associated with less hospital stay, earlier return of bowel activity, earlier resumption of oral intake without the use of the regular anti-emetics with better pain control and perception postoperatively. Moreover, it was associated with less surgical site infections and general complications including the respiratory ones than the open operation. We had similar anastomotic leak rates and early recurrence rate between both operations. Finally, the laparoscopic operation was associated with more operative time compared to the open operation

Conclusion: Laparoscopic left hemicolectomy and sigmoidectomy are oncologically sound when compared to the open left hemicolectomy and sigmoidectomy for treating left sided and sigmoid cancers. Moreover the laparoscopic approach yielded better outcomes regarding the postoperative recovery compared to the open approach

Recommendation: A further high volume study is needed to assess the long term effects of both procedures in our hospital

Percutaneous image guided lumbar disc nucleoplasty: a minimal invasive technique for lumbar disc decompression

Nucleoplasty is a minimally invasive, percutaneous procedure that uses radiofrequency energy to ablate nuclear material and create small channels within the disc. To evaluate the efficacy of nucleoplasty technique in patients with leg pain caused by radicular encroachment. This study was performed on 29 patients [23 males and 6 females] with lumbar disc prolapse causing unilateral sciatica with or without lower back pain for duration more than 3 months with no response to conservative treatment[in the form of medications, bed rest, and physiotherapy] in the period from November 2006 to November 2008. The Perc-D Spine Wand with 1 mm diameter and bipolar tip was used for coblation and the coagulation on the disc utilizing both radiofrequency coblation technology and thermal technology using a radiofrequency Arthrocare [Trade mark] generator system 2000 [Arthrocare Corporation [Trade mark], Sunnyvale, CA] to generate coblation and coagulation energy. The mean visual analogue score [VAS] for the treated patients preoperative was 8.3 and there was significant reduction in VAS in follow-up visits with the mean VAS = 3.4, 3.2, 2.5, 3.1, 3.5 at 1 week, 1 month, 3 months, 6 months, and 1 year duration respectively. All patients were satisfied with the procedure and the degree of pain relied at all follow-up visits. Percutaneous image guided lumbar disc decompression using nucleoplasty technique seems to be an effective, safe, simple and minimal invasive procedure for relief for sciatica due to lumbar disc prolapse in well selected cases. Nonetheless a longer follow-up period and a larger number of patients is needed to assess the long-term efficacy of this procedure

Evaluation of laparoscopic trans-abdominal preperitoneal repair of recurrent inguinal hernia

Fifteen adult male patients with recurrent inguinal hernia were treated with laparoscopic transabdominal preperitorteal repair [TAPP]. Controllable intraoperative complications were recorded in 3 patients [20%] with no conversion to open. No major postoperative complications were encountered. The mean operative time was 77.3 minutes. The mean time of ambulation out of the bed was 10.3 hours and the mean hospital stay was 19.8 hours. The mean time to return to usual social activity was 8.5 days. During the short period of follow up [6-24 months] no recurrence was reported. Long term follow up is needed for proper evaluation of this new procedure

Radiographic and electromyographic study of patients wearing complete overdentures with two different types of attachments

This study was carried out on twenty patients having edentulous maxillary jaw against mandibular jaw which had two retained teeth one on each side. The patients were divided into two groups. For group A an overdenture retained with flexi-post [resilient] attachment was constructed while for B an overdenture retained by post and core [rigid] was constructed. These two types of overdentures were studied by evaluating their effects on alveolar bone, residual ridge and on the electromyographic activity of masseter muscle. All these examination were done at the time of insertion, after 6 months and after one year. The results of this work showed no significant difference between the two groups in all readings