comparative study between sinotomy with or without marsupialization versus sinotomy and primary closure with or without drain in the management of pilonidal sinus

Background: pilonidal sinus [PNS] is a common condition. Although many methods for treatment are available, there is no consensus on the optimal treatment

Aim of the study: The aim of the work was to compare the outcome of sinotomy procedure with or without marsupialization versus sinectomy and primary closure with or without drain in the management of pilonidal sinus as regards operative times, postoperative complications, and time of healing and return of work

Patients and Methods: This is a comparative randomized comparative study. Sixteen patients undergoing surgery for primary PNS were enrolled. The patients were randomized into four groups. Each group included 15 patients. Group A underwent sinotomy without marsupialization; group B underwent sinotomy with marsupialization; group C underwent limited excision and primary closure with a drain and group D underwent the same procedure as group C but without drain. Each patient was followed up for 6 months

Results: Significantly short operative time was recorded in group B. Postoperative wound complications occurred in 3.2% of patients in group A, in 1.7% of patients in B, in 7.4% of patients in group C and in 4.2% of patients in group D. Recurrence rate was a slightly higher in group C but with no statistical significance

Conclusion: The sinotomy with marsupialization for treatment of PNS is superior to excision with primary closure either with or without a drain and sinotomy without marsupialization

Comparison between pre-operative fine needle aspiration cytology and intra-operative frozen section biopsy in the diagnosis of solitary thyroid nodule

Controversy continues to exist concerning the diagnosis of solitary thyroid nodule. Even today there is a wide spread disagreement as to the best method of establishing a definitive diagnosis. Fine needle aspiration cytology [FNAC] is a standard diagnostic procedure for patients with solitary thyroid nodule and the necessity for frozen section [FS] intraoperative biopsy has been the subject of discussion. The purpose of this study is to compare between preoperative FNAC and intraoperative FS biopsy in the diagnosis of solitary thyroid nodule. Twenty patients [17 women and 3 men with mean age 36.5, range 23-64 years] suffering from solitary thyroid nodule were admitted to hospital. Combined preoperative FNAC and intraoperative FS examination were assessed in all patients. In the benign cytology, the diagnostic accuracy was 78.6% for FNAC and 100% for FS biopsy. In those with suspicious cytology [cellular FNAC diagnosis], the diagnostic accuracy was 15% for FNAC and 95% for FS biopsy. In those with malignant cytology, the diagnostic accuracy was 50% for preoperative FNAC and 83.3% for intraoperative FS biopsy

recent approach to the surgical treatment of reflux oesophagitis

The rationale of combining proximal gastric vagotomy with Nissen fundoplication in the treatment of reflux oesophagitis due to hiatus hernia is discussed. This was applied to 20 cases over the period of 7 years at Al-Azhar university hospitals 1983-1992. The results were reported with follow up for about 2 years, patients were completely relieved and one had been significantly improved