Chemosystematic studies of some species of the genus potamogeton L. in Egypt

Morphological, anatomical and a phytochemical studies were conducted on four out of seven potamogeton L. species recorded in the flora of Egypt. The stem anatomy referred to the presence of three types of steles and three types of endodermis. The chemical investigation revealed the presence of eleven flavonoid compounds, the distribution of which was traced in the studied species to evaluate the interspecific affinity through this parameter It was found that the chemical data in this work justify the classification of ascherson and graebner [1907] as regards the assignment of the four studied species to their sections. A key based on a combination of the anatomical and chemical characters was suggested for species delimitation

Use of colonic pouches in treatment of mid and low rectal cancer: better patient selection result in better functional outcome

This study was conducted to evaluate the selective use of colonic pouches based upon the diameter of the proximal colon. Twenty-nine rectal cancer patients underwent ultra-low anterior resection or colon anastomosis were included in this study, 17 had a stapled straight anastomosis, while 12 had a stapled colonic pouch-anal anastomosis. Colonic pouches resulted in a superior functional result in the first six months postoperatively compared with straight anastomoses. Pouch patients had less frequency, urgency and need for constipating drugs. None of the pouch patients had evacuation difficulties. Adaptation of straight anastomosis patients resulted in comparable bowel function after six months in most of the patients

Internal colonic fistulae: experience with en-bloc extended low anterior resections

Thus study was undertaken to assess the results of using extended en bloc low anterior resection in patients with internal colonic fistulae regardless of the aetiology of the fistula. Eighteen patients [10 women, 66%; 8 men, 44%] who ranged in age from 23 to 86 years [median 67.5 years] were seen between 1996 to early 2000. The types of fistulas included 8 colovesical [44%], 5 colovaginal [28%] and 3 coloenteric [17%]. Two patients had complex fistulae involving more than 2 organs [11%]. The cause of the fistula was diverticulitis in 10 patients [56%] cancer in 5 patients [28%], Crohn's disease in 2 patients [11%] and localized bowel ischaemia in 1 patient [6%]. Fifteen patients [83%] had definitive en bloc resections, while 3 patients had diverting transverse loop colostomy only because of advanced malignancy. Stapled low anterior resection en bloc- with a second organ and omental interposition was performed in 11 patients [9 patients had omental interposition and 3 had covering stomas]. En bloc colonic and small bowel resections with hand-sewn anastomoses was done in 3 patients, One patient had a Hartmann's procedure. The hospital stay ranged from 6 to 63 days [median 12 days]. There were no operative deaths and no clinical anastomotic leaks. The postoperative course was uncomplicated in 72%, while 5 patients [28%] experienced complications. En bloc radical resections with primary anastomosis can be accomplished safely in patients with internal colonic fistulae. Extended resections allow safe anastomosis to be carried out in pliable non-inflammed tissues, guards against future recurrence of diverticulitis without any increase in morbidity. They also ensure adequate resections in cancer patients and when the diagnosis is in doubt

Bridge suspension in the treatment of circumferential prolapsed haemorrhoids

Thirty-six patients [13 men and 23 women] with prolapsed circumferential hemorrhoids were prospectively randomized into classical Milligan and Morgan diathermy hemorrhoidectomy [group I, 18 patients] or Milligan and Morgan diathermy hemorrhoidectomy with bridge suspension [group II, 18 patients]. The results have shown that the median follow up was eight months in both groups [range 3-15 months]. Only one recurrence at the site of previous bridge suspension was observed in group II, which needed further surgery. Twelve of the patients in group I had residual hemorrhoids and in seven, they were symptomatic and needed further surgery

Microdiscectomy versus hemilaminectomy for lumbar disc prolapse

This study was performed to detect the advantages of microdiscectomy over hemilaminectomy in terms of postoperative hospital stay, postoperative mobilization, early postoperative results, return to work and complications of both procedures during eight months of follow up. Forty two patients were classified into two groups. Both groups were homogenous and cross matched in regard to age, sex, occupation, duration of sciatica. one group was treated by hemilaminectomy and the other by microdiscectomy. The results showed that in microdiscectomy group there was an early ambulation, short duration of postoperative hospital stay and early return to work

Laparoscopic repair of groin hernias [a unified approach]

A tension free repair of groin hernias was evaluated in this study regarding postoperative pain, early return to work and the recurrence rate. Sixty patients with groin hernias were managed laparoscopically by different techniques in the period between May 1991 and May 1994. Thirty patients managed by the technique of laparoscopic transabdominal pre-peritoneal placement of large polypropylene [prolene] mesh [av. size 13 x 9.5 cm] were included in this study. Meshes were fixed in place using a hernial stapler. The peritoneum was closed by overcasting 3/0 PDS. This technique was unified in the management of inguinal, femoral and recurrent hernias. The study comprised 14 indirect, 6 direct, 6 recurrent and 4 femoral hernias. The average operative time was 2 hours, the average hospital stay was 1 day and all patients returned to their normal activities within 1 week except one patient complained of postoperative upper thing pain and he resumed his normal activity after 2 weeks. No recurrence was detected in a mean follow-up period of 12.3 months. In 4 cases additional hernias were discovered accidentally during the operation and managed synchronously. The results of this limited series point to the reliability and safety of this technique as a unified approach to groin hernias

Surgery for rectal prolapse: the role of Delorme's operation

Eighteen patients with rectal prolapse were treated with Delorme's operation over 3 years period, with a median follow-up of 22 months. There was no mortality. Two patients suffered from postoperative complications [ischaemic necrosis of the rectal muscle in 1 and minor bleeding from the suture line in 1]. Five patients suffered from incontinence preoperatively. Six patients had constipation preoperatively. Four of the 6 patients [67%] with preoperative constipation improved postoperatively. Two constipated patients did not improve, but were not made worse. Three of the 5 the patients [60%] with preoperative incontinence regained continence postoperatively. Two recurrences [11.1%] were seen [one small full thickness recurrence [5.5%] and one [5.5%] minor mucosal prolapse recurrence]. The many advantages of Delorme's operation over abdominal rectopexy [Regional anaesthesia, suitable for poor risk patients, no risk of impotence or pelvic adhesions and no risk of worsening constipation and a moderately low incidence of recurrence] suggest that it is a suitable and viable alternative in patients with rectal prolapse, especially, in males, those with constipation and those unfit for more major surgery